Abstracts

Sudden unexpected death in epilepsy (SUDEP) is an important cause of death among epilepsy surgery patients. The aim of this study was to determine the mortality rate due to SUDEP in patients who had epilepsy surgery at the Hospital Brigadeiro Epilepsy Unit (S[atilde]o Paulo, Brazil). Nine hundred and fifty patients who underwent epilepsy surgery between January 1996 and January 2005 were included in the study. All subjects had been followed up until January 2005. During the study period, two SUDEP episodes occurred. Both patients died during the early stage after surgical procedures. No SUDEP occurred among the remaining 948 patients who had epilepsy surgery even after long term follow-up. Patient I: This 32 years-old man had simple and complex partial seizures since the age of 8 (seizure[apos]s frequency, 1-2 / week). MRI disclosed right mesial temporal sclerosis. He was submitted to an uneventful right cortico-amygdalo-hippocampectomy. By Day 9 after surgery, he was packing together with his mother to leave the Hospital and presented SUDEP. Necropsy showed no pathological substrate for SUDEP. Patient II: This 18 years old boy had postural frontal lobe seizures since the age of 2. MRI was normal. Ictal and interictal video-EEG showed secondary bilateral synchrony. He was submitted to bifronto-mesial subdural electrodes implantation. On the second post-operative day, he was having breakfast, waiting to be transferred to the Video-EEG Unit and presented SUDEP. Necropsy showed no pathological substrate for SUDEP. The unexplained cause of SUDEP in patients with refractory epilepsy still remains a challenge. Our results suggest that SUDEP[apos]s incidence might be lower in our populatiom than that noted in other studies, especially in those reporting on chronically refractory epileptic patients. (Supported by FAEP, FAPESP, CNPq and CAPES.)