Open Access“Saved by the Bell”: Near SUDEP during intracranial EEG monitoring
Author(s) -
BaArmah Duaa M.,
Donner Elizabeth J.,
Ochi Ayako,
Go Cristina,
McCoy Bláthnaid,
Snead Carter,
Drake James,
Jones Kevin C.
Publication year - 2018
Publication title -
epilepsia open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.247
H-Index - 16
ISSN - 2470-9239
DOI - 10.1002/epi4.12093
Subject(s) - electroencephalography , bradycardia , epilepsy , medicine , apnea , cortical dysplasia , anesthesia , hypoventilation , epileptic seizure , hyperventilation , respiratory system , blood pressure , heart rate , psychiatry
Summary SUDEP is the sudden unexpected death of a person with epilepsy, when no structural or toxicological cause of death can be found. The majority of witnessed cases are reported to be preceded by a convulsive seizure and postictal hypoventilation. Here, we report an 8‐year‐old girl with drug‐resistant focal seizures secondary to a focal cortical dysplasia type II b. While undergoing invasive intracranial monitoring with subdural and depth electrodes, she had a clinical apnea event recorded on video, followed by bradycardia, which required resuscitation. Her intracranial electroencephalogram ( EEG ) during the event showed diffuse slowing and attenuation of cortical activity, with bradycardia that responded to positive pressure ventilation with oxygen. This near SUDEP event was not preceded by either an electroclinical or electrographic seizure. This is the first report of a witnessed, near‐ SUDEP event during intracranial monitoring. It emphasizes the fact that near‐ SUDEP can occur without a preceding seizure.