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sudden unexpected death

Lliwen A Jones, Rhys H Thomas
Sudden unexpected death in epilepsy (SUDEP) is the leading cause of mortality in patients with refractory epilepsy, and as such has been a major research focus over the last 25 years. The earliest SUDEP research papers were published in Seizure, as have scores of SUDEP papers since. In this review we discuss the efforts to try and describe the pathophysiological basis of SUDEP, the drive to discover the clinical risk factors that increase the likelihood of SUDEP, and the motivation to increase awareness of SUDEP...
October 14, 2016: Seizure: the Journal of the British Epilepsy Association
Roisin Bartlam, Rajiv Mohanraj
BACKGROUND: Seizures can lead to cardiac arrhythmias by a number of mechanisms including activation/inhibition of cortical autonomic centers, increase in vagal tone through activation of brainstem reflex centers, and respiratory failure. Ictal asystole (IA) is a potential mechanism underlying sudden unexpected death in epilepsy (SUDEP). We analyzed the clinical features of 5 patients who developed IA requiring pacemaker implantation. METHODS: Patients with ictal arrhythmias were identified from the video-telemetry and ambulatory EEG database at Greater Manchester Neurosciences Centre, as well as an independent epilepsy residential care facility...
October 13, 2016: Epilepsy & Behavior: E&B
Carl L Faingold, Marcus Randall, Chang Zeng, Shifang Peng, Xiaoyan Long, Hua-Jun Feng
Drugs that enhance the action of serotonin (5-hydroxytrypamine, 5-HT), including several selective serotonin reuptake inhibitors (SSRIs), reduce susceptibility to seizure-induced respiratory arrest (S-IRA) that leads to death in the DBA/1 mouse model of sudden unexpected death in epilepsy (SUDEP). However, it is not clear if specific 5-HT receptors are important in the action of these drugs and whether the brain is the major site of action of these agents in this SUDEP model. The current study examined the actions of agents that affect the 5-HT3 receptor subtype on S-IRA and whether intracerebroventricular (ICV) microinjection of an SSRI would reduce S-IRA susceptibility in DBA/1 mice...
October 12, 2016: Epilepsy & Behavior: E&B
Ann M Mitchell, Lauren Terhorst
BACKGROUND: Although bereavement is not usually considered the type of stressor associated with posttraumatic stress disorder (PTSD), a risk factor often associated with poorer bereavement outcomes is when a death is sudden and unexpected. AIMS: The purpose of this exploratory study is to describe PTSD symptoms in survivors bereaved by the suicide of a significant other. The relationship of PTSD to mental health and grief were explored, as well as gender differences in PTSD symptoms...
October 14, 2016: Journal of the American Psychiatric Nurses Association
Britt M Blokker, Annick C Weustink, M G Myriam Hunink, J Wolter Oosterhuis
INTRODUCTION: Hospital autopsies, vanishing worldwide, need to be requested by clinicians and consented to by next-of-kin. The aim of this prospective observational study was to examine how often and why clinicians do not request an autopsy, and for what reasons next-of-kin allow, or refuse it. METHODS: Clinicians at the Erasmus University Medical Centre were asked to complete a questionnaire when an adult patient had died. Questionnaires on 1000 consecutive naturally deceased adults were collected...
2016: PloS One
Wayne A Ray, Cecilia P Chung, Katherine T Murray, Kathi Hall, C Michael Stein
OBJECTIVE: Studies demonstrating that higher doses of citalopram (> 40 mg) and escitalopram (> 20 mg) prolong the corrected QT interval prompted regulatory agency warnings, which are controversial, given the absence of confirmatory clinical outcome studies. We compared the risk of potential arrhythmia-related deaths for high doses of these selective serotonin reuptake inhibitors (SSRIs) to that for equivalent doses of fluoxetine, paroxetine, and sertraline. METHODS: The Tennessee Medicaid retrospective cohort study included 54,220 persons 30-74 years of age without cancer or other life-threatening illness who were prescribed high-dose SSRIs from 1998 through 2011...
October 11, 2016: Journal of Clinical Psychiatry
Sharon Shmuely, Sanjay M Sisodiya, W Boudewijn Gunning, Josemir W Sander, Roland D Thijs
INTRODUCTION: Premature mortality is a major issue in Dravet syndrome (DS). To improve understanding of DS premature mortality, we conducted a comprehensive literature search with a particular emphasis on SUDEP. METHODS: We searched PubMed, Embase, Web of Science, Cochrane, CENTRAL, CINAHL, PsycINFO, Academic Search Premier, and ScienceDirect on the following terms: "Dravet syndrome", "severe myoclonic epilepsy", "SMEI", "mortality", "survivors", "prognosis", and "death"...
October 9, 2016: Epilepsy & Behavior: E&B
Ali Torkamani, Evan D Muse, Emily G Spencer, Manuel Rueda, Glenn N Wagner, Jonathan R Lucas, Eric J Topol
No abstract text is available yet for this article.
October 11, 2016: JAMA: the Journal of the American Medical Association
B S Van Deventer, S H Rossouw, L Du Toit-Prinsloo
BACKGROUND:  Sudden and unexpected death is well known to occur in infants, and although sudden deaths are less frequent after the first birthday, they still account for a significant proportion of childhood deaths. In 2009, 1.9% of the total deaths in the USA were childhood deaths. In South Africa (SA) this proportion was much higher at 11.85%. According to the law, sudden and unexpected deaths are generally investigated as unnatural deaths. Establishing an exact underlying anatomical cause of death will depend on available resources and can be difficult in a substantial proportion of cases...
September 6, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Srinivasa P Kommajosyula, Marcus E Randall, Srinivasan Tupal, Carl L Faingold
Patients with epilepsy are at risk of sudden unexpected death in epilepsy (SUDEP). The most common series of events in witnessed cases of SUDEP is a generalized convulsive seizure followed by terminal apnea. Risk factors for SUDEP include prolonged postictal depression (PID), as well as alcohol abuse. The present study examined these issues in a genetic epilepsy model that exhibits generalized convulsive audiogenic seizures (AGSz) but rarely exhibits seizure-induced death, the genetically epilepsy-prone rats (GEPR-9s)...
October 7, 2016: Epilepsy & Behavior: E&B
Iwona Mańka-Gaca, Beata Łabuz-Roszak, Agnieszka Machowska-Majchrzak, Zbigniew Kalarus, Beata Średniawa, Krystyna Pierzchała
INTRODUCTION: Electrocardiographic abnormalities in patients with epilepsy are related to the presence of discharges in central autonomic structures and the effect of antiepileptic drugs. These patients are at risk for sudden unexpected death, and cardiac arrhythmias are one of the most probable causes related to it. THE AIM: The heart rate (HR) assessment recorded on electrocardiography (ECG) in the interictal period in patients with newly diagnosed and previously treated epilepsy, depending on the type of changes in electroencephalography (EEG) and the treatment option...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Giulia Ottaviani
Crib death, or sudden infant death syndrome (SIDS), is the most frequent form of death in the first year of life, striking one baby in every 1,700-2,000. Yet, despite advances in maternal-infant care, sudden intrauterine unexplained/unexpected death syndrome (SIUDS) has a sixfold to eightfold greater incidence than that of SIDS. Frequent congenital abnormalities, likely morphological substrates for SIDS-SIUDS, were detected, mainly represented by alterations of the cardiac conduction system, such as accessory pathways and abnormal resorptive degeneration, and hypoplasia/agenesis of the vital brainstem structures...
2016: Frontiers in Pediatrics
Imed Gaaloul, Samira Riabi, Mark Evans, Timothy Hunter, Sally Huber, Mahjoub Aouni
Coxsackieviruses B (CV B) are known as the most common viral cause of human heart infections. Cardiac inflammations contribute to sudden unexpected death (SUD) significantly. The diagnosis remains difficult with the traditional diagnostic tests and must be substantially improved. This has prompted health professionals to seek new diagnostic procedures which may provide important clues regarding underlying etiology. The present study is based on patients with infectious heart diseases and SUD victims with no relevant pathologies...
September 22, 2016: Forensic Science International
Joanna Sweeting, Christopher Semsarian
Athletes are often regarded as individuals at the pinnacle of health and fitness, nearly to the point of invincibility. The sudden cardiac death (SCD) of an athlete is therefore generally unexpected and extremely traumatic. Some of the most commonly identified causes of SCD in athletes include the genetic heart diseases. Despite thorough clinical and genetic investigation, in some cases a cause of death cannot be elucidated. Further research in these areas, spanning clinical, genetic, and public health perspectives, is required to help guide clinicians and those encountering the tragedy of SCD in an athlete...
November 2016: Cardiology Clinics
S Keddie, H Angus-Leppan, T Parker, S Toescu, A Nash, O Adewunmi, Rsn Liu
OBJECTIVE: To examine patient knowledge about sudden unexpected death in epilepsy (SUDEP) compared to other risks in epilepsy. To explore patients' experiences surrounding SUDEP disclosure and opinions on how information should be delivered. DESIGN: A cross-sectional questionnaire. SETTING: Royal Free Hospital, London outpatient epilepsy clinics. PARTICIPANTS: New and follow-up patients attending epilepsy clinics at a London teaching hospital over six months...
September 2016: JRSM Open
Kathleen L Meert, Russell Telford, Richard Holubkov, Beth S Slomine, James R Christensen, J Michael Dean, Frank W Moler
OBJECTIVE: To investigate relationships between cardiac arrest characteristics and survival and neurobehavioral outcome among children recruited to the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial. DESIGN: Secondary analysis of Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial data. SETTING: Thirty-six PICUs in the United States and Canada. PATIENTS: All children (n = 295) had chest compressions for greater than or equal to 2 minutes, were comatose, and required mechanical ventilation after return of circulation...
September 27, 2016: Pediatric Critical Care Medicine
Johan J Dempers, Jean Coldrey, Elsie H Burger, Vonita Thompson, Shabbir A Wadee, Hein J Odendaal, Mary Ann Sens, Brad B Randall, Rebecca D Folkerth, Hannah C Kinney
The rate for the sudden infant death syndrome (SIDS) in Cape Town, South Africa, is estimated to be among the highest in the world (3.41/1000 live births). In several of these areas, including those of extreme poverty, only sporadic, nonstandardized infant autopsy, and death scene investigation (DSI) occurred. In this report, we detail a feasibility project comprising 18 autopsied infants with sudden and unexpected death whose causes of death were adjudicated according to the 1991 NICHD definitions (SIDS, n = 7; known cause of death, n = 7; and unclassified, n = 4)...
September 27, 2016: Journal of Forensic Sciences
Elizabeth G Damato, Madeline C Haas, Pamela Czeck, Donna A Dowling, Sarah Gutin Barsman
BACKGROUND: The high prevalence of prematurity and low birth-weight places twin infants at increased risk for sudden unexpected infant death (SUID) and/or sudden infant death syndrome (SIDS). Risk for these SUID and SIDS is affected by a combination of nonmodifiable intrinsic risk factors and modifiable extrinsic stressors including infant care practices related to sleep. Although adherence to the full scope of American Academy of Pediatrics (AAP) 2011 recommendations is intended to decrease risk, these recommendations are aimed at singleton infants and may require tailoring for families with multiple infants...
September 19, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Niyada Naksuk, Tiffany Hu, Chayakrit Krittanawong, Charat Thongprayoon, Sunita Sharma, Jae Yoon Park, Andrew N Rosenbaum, Prakriti Gaba, Ammar M Killu, Alan M Sugrue, Thoetchai Peeraphatdit, Vitaly Herasevich, Malcolm R Bell, Peter A Brady, Suraj Kapa, Samuel J Asirvatham
BACKGROUND: Although electrolyte disturbances may affect cardiac action potential, little is known about the association between serum magnesium and QTc interval as well as clinical outcomes. METHODS: A consecutive 8,498 patients admitted to the Mayo Clinic Hospital - Rochester cardiac care unit (CCU), from January 1, 2004 through December 31, 2013, with two or more documented serum magnesium levels, was studied in order to test the hypothesis that serum magnesium levels are associated with in-hospital mortality, sudden cardiac death and corrected QT interval (QTc) interval...
September 14, 2016: American Journal of Medicine
Anthony S Kim, Ellen Moffatt, Philip C Ursell, Orrin Devinsky, Jeffrey Olgin, Zian H Tseng
OBJECTIVE: To characterize the frequency of and risk factors for out-of-hospital sudden neurologic deaths. METHODS: During the initial 25 months (February 1, 2011-March 1, 2013) of the San Francisco Postmortem Systematic Investigation of Sudden Cardiac Death Study, we captured incident WHO criteria sudden cardiac deaths (SCDs) through active surveillance of consecutive out-of-hospital deaths, which must be reported to the medical examiner by law. All cases were referred for full autopsy with detailed examination of the heart and cranial vault, toxicology, and histology...
October 18, 2016: Neurology
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