SUDEP in patients with epilepsy and nonepileptic seizures.

We report 13 SUDEP cases in the North American SUDEP Registry with both psychogenic nonepileptic seizures (PNES) and epileptic seizures (ES) among a consecutive series of 231 cases (excluding epileptic encephalopathies). On average, cases of PNES + ES died at a younger age (23 ± 11 years) than the ES-only cohort (30 ± 14 years), and died an average of 3 years after PNES diagnosis. We found no statistically significant confounding cardiac, respiratory, or psychiatric comorbidities and equal rates of anti-seizure medication adherence, although there was a trend for higher rates of psychiatric disorders in the PNES group. Our findings confirm that patients with comorbid ES and PNES can die from SUDEP and that there may be a high-risk period after the diagnosis of PNES is made in patients with comorbid ES. Such patients should be closely monitored and provided with coordinated care of both their epilepsy and psychiatric disorder(s).

Déclaration de conflit d'intérêts

Daniel Friedman serves on the executive committee of the North American SUDEP Registry and is on the advisory board of the Epilepsy Foundation of America SUDEP Institute. He has performed contracted research for Epitel, Empatica, and Neuropace. He holds ownership interest in Neuroview Technology. He receives salary support from the nonprofit Epilepsy Study Consortium. He has consulted or serves on advisory boards for Eisai and Penumbra. He has received an honorarium for educational materials from Neuropace. He also receives research support from NINDS, Epilepsy Foundation, the Centers for Disease Control and Prevention, and UCB Pharmaceuticals. Orrin Devinsky has equity interest/role on advisory board for: Receptor Life Sciences (Chief Medical Officer), Tilray, Engage, Papa and Barkley, Empatica, Q‐state, and Rettco. He is Principal Investigator for the North American SUDEP Registry and services on the Executive Committee for the Epilepsy Foundation SUDEP Institute. Chloe Verducci reports no competing financial disclosures. We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.