ABSTRACT
Nearly a quarter century ago, Leestma et al. (1985) described the ndings seen at autopsies of 66 epileptics who had died unexpectedly during or just aer experiencing a seizure. e autopsy ndings were insucient to explain the cause of death in any of the cases. e syndrome of sudden death during or immediately aer a seizure has come to be called sudden unexplained death in epilepsy (SUDEP). Over a 10-year period, the mean age of epileptics with SUDEP in Leestma’s studies was 31.4 years. Of these, 37% were found dead in bed, 49% were black males, 25% were white males, 11% were black females, and 15% were white females ranging in age from 10 months to 60 years (mean age, 28 years); nearly half of the decedents were found “dead in bed,” a description that applies equally well to deaths from long QT syndrome (LQTS), an entity due to heritable channelopathies (Ackerman et al. 2001), or to diabetes with hypoglycemia (Rothenbuhler et al. 2008; Tu et al. 2008). By convention, the abbreviation sudden unexplained death syndrome (SUDS) is used to describe the death of anyone older than 2 years who dies in this fashion, whereas for children 2 years and younger, the diagnosis that is used is sudden infant death syndrome (SIDS). More recently, a similar syndrome has been recognized in young diabetics (Gill et al. 2009). As with SUDEP, the cause of death is not apparent in any of these disorders, although it seems probable that an explanation is to be found only at the molecular level.
