ABSTRACT

Sudden Unexpected Death in Epilepsy (SUDEP) is generally defined as sudden, unexpected, witnessed or unwitnessed, non-traumatic, and non-drowning death in patients with epilepsy, excluding documented status epilepticus. Reported SUDEP cases in Turkey are limited. Two cases of patients who died with diagnosis of probable SUDEP are described in the present report. Case 1: A 33-year-old female patient with generalized tonic-clonic seizures for nearly 20 years was referred to the clinic because of lack of complete seizure control despite years of different antiepileptic drug combinations. While in treatment, patient had a healthy pregnancy and seizure control was achieved with lamotrigine. Upon recurrence of seizures after pregnancy, valproate 300 mg/day was added to lamotrigine 150 mg/day. Patient died with diagnosis of probable SUDEP 2 years after the birth of the child. Case 2: A 42-year-old female patient with intractable complex partial and secondary generalized tonic-clonic seizures for about 30 years was admitted to the clinic. She had a history of epilepsy surgery. Topiramate therapy was added to carbamazepine 1200 mg/day and levetiracetam 2000 mg/day treatment. Subsequently, posterior temporal resection was performed, vagal nerve stimulation (VNS) was applied and barbexaclone 25 mg/day was added. Five months after the application of VNS, the patient died with diagnosis of probable SUDEP. These 2 cases of probable SUDEP may contribute to increased awareness of SUDEP and its features among neurologists.

Keywords: Death, epilepsy, SUDEP