Abstracts

Summary: Sudden unexpected death in epilepsy (SUDEP) is a markedly underreported catastrophe bedeviling people with epilepsy (particularly chronic epilepsy) and their carers. The pathophysiology of this baffling condition is not fully understood. The unpredictability of these events and current pathophysiological hypotheses are the subject of this workshop. We will review the epidemiology of this condition which is unfortunately not uncommon amongst people with chronic epilepsy. A discussion of the relevance of the neurodynamics of epilepsy and how it relates to the unpredictability of seizures in general and to SUDEP in particular will follow. The dominant hypothesis of seizure-related central apnea and seizure-related cardiac arrhythmias, and contributing clinical and possibly anatomical factors will then be elaborated. Finally, from a cellular perspective, hypotheses regarding how seizures can cause respiratory arrest, focusing on the role of seizure-induced raised potassium initiating respiratory neuronal shutdown, will be discussed. Vigorous and animated discussion is expected on this critical problem in epilepsy care.