Related Experiment Video
Updated: Sep 8, 2025

Multi-system Monitoring for Identification of Seizures, Arrhythmias and Apnea in Conscious Restrained Rabbits
Published on: March 27, 2021
Electrophysiological and clinical markers of SUDEP risk in pediatric epilepsy
Pinar Ozbudak1, Salih Akbas2, Alev Elci Karaduman3
1Department of Pediatric Neurology, Ankara Etlik City Hospital, Ankara, Turkey.
Insights
Postictal generalized EEG suppression (PGES) is linked to higher SUDEP-7 scores in children, suggesting increased risk. Integrating EEG and body position monitoring may improve risk assessment for pediatric epilepsy patients.
Area of Science:
- Neurology
- Epileptology
- Pediatric Medicine
Background:
- Sudden unexpected death in epilepsy (SUDEP) is a significant cause of mortality in epilepsy, particularly drug-resistant forms.
- Limited pediatric data and lack of specific risk assessment tools hinder effective SUDEP risk management in children.
- Understanding factors associated with SUDEP risk is crucial for developing targeted interventions.
Purpose of the Study:
- To evaluate the association between peri-ictal prone positioning, postictal generalized EEG suppression (PGES), and SUDEP-7 Inventory scores in pediatric epilepsy patients.
- To identify potential biomarkers for SUDEP risk in children.
- To explore the utility of existing risk assessment tools in a pediatric population.
Main Methods:
- Retrospective review of 273 generalized convulsive seizures (GCS) from 117 pediatric patients undergoing video-EEG monitoring.
- Assessment of seizure body position (prone vs. non-prone), PGES presence/duration, and SUDEP-7 Inventory scores.
- Statistical comparisons between PGES-positive and -negative subgroups, and prone vs. non-prone seizure positions.
Main Results:
- Postictal generalized EEG suppression (PGES) was observed in 50.4% of patients, with a mean duration of 120.5 seconds.
- SUDEP-7 scores were significantly higher in PGES-positive patients (mean 7.04) compared to PGES-negative patients (mean 6.36; p=0.031).
- Daytime GCS occurred significantly earlier after sleep onset (53.3 min) than nighttime GCS (131.4 min; p=0.001).
Conclusions:
- Postictal generalized EEG suppression (PGES) is a reliable marker associated with higher SUDEP-7 scores, indicating potential increased SUDEP risk in children.
- The SUDEP-7 Inventory, despite limitations, remains the most accessible clinical tool for pediatric SUDEP risk assessment.
- Integrating EEG data and body position metrics can enhance individualized monitoring for pediatric epilepsy patients at risk of SUDEP.
Objective:
Sudden unexpected death in epilepsy (SUDEP) is a major cause of epilepsy-related mortality, especially in patients with drug-resistant epilepsy. However, pediatric data remain limited, and specific risk assessment tools for children are lacking. This study evaluates the association between peri-ictal prone positioning, postictal generalized EEG suppression (PGES), and SUDEP-7 Inventory scores in pediatric patients with epilepsy.
Methods:
A retrospective review was conducted on 273 generalized convulsive seizures (GCS) from 117 pediatric patients who underwent video-EEG monitoring from 2002 to 2022. We assessed body position during seizures, PGES presence and duration, and SUDEP-7 Inventory scores. Statistical comparisons were made across PGES-positive and -negative, and prone vs. non-prone subgroups.
Results:
Prone positioning occurred in 5.86% of seizures, with 91.6% of prone-onset seizures remaining in the prone position throughout. PGES was present in 50.4% of patients (mean duration: 120.5 s). SUDEP-7 scores were significantly higher in PGES-positive patients (mean: 7.04) compared to PGES-negative (mean: 6.36; p = 0.031). Daytime GCS occurred significantly earlier after sleep onset than night time GCS (53.3 vs. 131.4 minutes; p = 0.001).
Significance:
PGES appears to be a reliable marker associated with higher SUDEP-7 scores and may indicate increased SUDEP risk in children. While SUDEP-7 has limitations in pediatric use, it remains the most accessible clinical tool. Integrating EEG and body position metrics could enhance individualized monitoring for pediatric patients at risk.
More Related Videos
Related Concept Videos
Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
Seizures: Classification
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
Depolarizing Blockers: Pharmocokinetics

