Balancing Life and Risk: Assessing SUDEP Preventive Interventions to Improve Quality of Life: A Systematic Review
Alaa Abdelsamad1, Nafisa Mustafa1, Osama Abdelsamad3, Renda Mahgoub3, Nadir Abdelrahman2
1Family medicine, MSU, 2MSU, 3Michigan state university
Objective:
Our primary focus is to screen the preventive interventions in (SUDEP) while assessing their effects on patients' quality of life.
Background:
SUDEP (Sudden Unexpected Death in Epilepsy) is a distressing phenomenon where individuals with epilepsy die suddenly and inexplicably, representing the most common epilepsy-related cause of death. SUDEP prevention remains a critical area of investigation within epilepsy care as its exact mechanisms remain unclear. Preventive strategies involve reducing seizures (by considering epilepsy medications, surgery or making lifestyle changes), uses of seizure detection devices, nighttime supervision, and patient education to enhance awareness and medication adherence.
Design/Methods:
We searched Cochrane, Mesh PubMed, and the Google scholar database and identified pertinent randomized and non-randomized clinical trials. We used Covidence and ROBINS-I. to evaluate studies' qualities and risk of bias. Keywords used: SUPED and prevention strategies for SUDEP.
Results:
This study included 14 observational studies investigating the prevention strategies and comparing their quality-of-life effects. Four studies concluded that proper anti-epileptic treatment can render 70% of patient’s seizure-free, but about one-third still experience seizures, increasing their risk of SUDEP and reduced quality of life. Among the five studies assessing nighttime supervision and precautions to prevent SUDEP, two found these measures reduced the risk of SUDEP in 50% of patients with epilepsy. However, the other three studies with SUDEP cases did not show added preventive benefits. Interestingly, it revealed that the facility with the highest SUDEP rates had the lowest supervision levels and none of these studies reported changes in quality of life. Two studies highly recommenced using seizure detection devices. Three studies looked at the influence of patient education on medication adherence and one of them revealed no significant results.
Conclusions:
Using antiepileptic medication and medical devices may improve the quality of life. Therefore, More effort needs to evaluate the practical aspect of seizure detection device.