title: Sudden unexpected death in epilepsy (SUDEP): development of a safety checklist.
abstract: OBJECTIVE
  The incidence of sudden death appears to be 20 times higher in patients with epilepsy compared with the general population. Epilepsy-related death, particularly sudden unexpected death in epilepsy (SUDEP), is still underestimated by healthcare professionals and this may reflect the mistaken belief that epilepsy is a benign condition. The risk of death associated with epilepsy appeared rarely to have been discussed with patients or their families. It appears the decision to discuss SUDEP and also to peg SUDEP risk is arbitrary and clinical. Unfortunately there is no structured evidenced mechanism at present to represent person centered risk of SUDEP and there is currently no easy manner or template to have this discussion with the family and the patient.
  
  
  METHODS
  We conducted a detailed literature review in Medline, Embase and Psychinfo databases to extract the common risk factors as evidenced from literature till date. Research into risk factors has identified a number of risk factors for SUDEP, some of which are potentially modifiable.
  
  
  RESULTS
  Based on the literature review, we believe that the ascertained risk factors could be employed in clinical practice as a checklist to reduce an individual patient's risk of SUDEP. The SUDEP safety checklist may be of practical use in reducing risks in some individuals and is definitely of use in helping communication.
  
  
  CONCLUSIONS
  An evidence based checklist identifying the major risk factors can help both clinicians and patients to focus on minimizing certain risk factors and promote safety by focusing on the modifiable factors and guide treatment. It can be a tool to open a person centered discussion with patients and to outline how individual behaviors could impact on risk.
authors: MBBS, MRCPsych PGC-Cl. Research, PGC-Aspergers Consultant Neuropsychiatrist, Cornwall Partnership NHS Foundation Trust & Exeter medical school, United Kingdom. Electronic address: Rohit.shankar@cft.cornwall.nhs.uk.
authors: Rohit
authors: R
authors: Shankar
authors: David
authors: D
authors: Cox
authors: Virupakshi
authors: V
authors: Jalihal
authors: Scott
authors: S
authors: Brown
authors: Jane
authors: J
authors: Hanna
authors: Brendan
authors: B
authors: McLean
mesh_terms: D057189:Checklist; D003645:Death, Sudden / Q000209:etiology*; D004827:Epilepsy / Q000150:complications*; D006801:Humans; D012307:Risk Factors
keywords: Epilepsy deaths; Patient communication; Risk factors; SUDEP; Safety check list; Sudden unexpected death in epilepsy