Near-Sudden Unexpected Death in Epilepsy Rescued by Bystander Use of an Automated External Defibrillator: A Case of...

Sudden unexpected death in epilepsy (SUDEP) is the leading cause of mortality in people with epilepsy; however, it remains under-recognized by the general public and healthcare providers.

A 42-year-old man was transported to the emergency department in a coma after resuscitation with an automated external defibrillator by a caregiver. He had intellectual disability and uncontrolled seizures despite receiving multiple antiseizure medications for > 20 years. Electrocardiography showed no ST change or prolonged QTc interval. Emergency coronary angiography revealed no significant stenosis. The patient returned to the previous state after targeted temperature management at 34°C. Most SUDEP cases present generalized tonic-clonic seizures (GTCS), leading to respiratory arrest and asystole. Although ventricular fibrillation following a nonconvulsive seizure is exceptional, this patient had no cardiac factors and was consistent with SUDEP.

All healthcare providers caring for people with epilepsy should be aware of SUDEP to help prevent epilepsy-related deaths.