Editors' Note: Temporal Trends and Autopsy Findings of SUDEP Based on Medicolegal Investigations in the United States

In “Temporal Trends and Autopsy Findings of SUDEP Based on Medicolegal Investigations in the United States,” Cihan et al. reviewed medical examiner reports in 3 cities in the United States and found that although there was no correlation between sudden unexplained death in epilepsy (SUDEP) and diurnal patterns or time of year, there was a reduction in the incidence of SUDEP between 2009 and 2016. There was also no difference in autopsy findings between SUDEP- and non–SUDEP-related deaths associated with epilepsy. Bleasel was encouraged by these findings, which he attributed to increased awareness of SUDEP, access to affordable medical care, and prescribing antiseizure medications. However, he emphasized the importance of continued patient and family education about the risk of SUDEP, medication compliance, and treatment of comorbidities. He also noted that other studies have shown respiratory center neuronal cellular abnormalities in patients with SUDEP. Friedman et al. agreed that this positive trend is encouraging, but that it does not obviate the need to 1) counsel patients and families about SUDEP as part of general epilepsy care or 2) continue to pursue research to explain this reduction and minimize the risk of SUDEP as much as possible.

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