HMN 2025: How Breathing interruptions after seizures may be risk factor for unexpected death in epilepsy patients

Epilepsy patients who experience breathing interruptions after a seizure may be at a higher risk of sudden unexpected death later in life, according to researchers at UTHealth Houston.

The study, published in The Lancet, was a collaboration between eight centers in the United States and one in the United Kingdom and led by researchers with the Department of Neurology at McGovern Medical School at UTHealth Houston.

Over 10 years, the teams sought to identify risk factors for sudden unexpected death in epilepsy, or SUDEP.

SUDEP is the leading cause of epilepsy-related deaths but was largely an unexplained phenomenon prior to the publication of Wednesday’s research, said senior author Samden Lhatoo, MD, neurologist, professor, John P. and Kathrine G. McGovern Distinguished Chair, and director of the Texas Comprehensive Epilepsy Program at McGovern Medical School.

“Three-thousand people in the U.S. die every year from this. Up until now, we didn’t really understand how they died and why they died,” Lhatoo said. “This paper for the first time established that you can identify individual patients at risk, and you can actually characterize the risk markers that will identify people at highest risk of death, in order to put mitigative strategies in place to reduce mortality.”

In addition to prior incidents of breathing interruptions after seizures, living alone and having three or more seizures the previous year were identified by researchers as SUDEP risk factors.

The study focused on 2,468 children and adults with epilepsy who engaged in long-term cardiorespiratory monitoring at participating epilepsy centers between September 2011 and December 2021. Thirty-eight of the patients died from SUDEP during the study, while another two patients had near-SUDEP events.

The biggest takeaway from the study is the importance of monitoring breathing in epilepsy patients, Lhatoo said. But the findings also pave the way for research that rescues breathing lapses in epilepsy patients.

“This is a major advance for the epilepsy community,” Lhatoo said.

The content is provided for information purposes only.