67. A case of sudden unexpected death in epilepsy (SUDEP) in a patient affected by septic shock

• Published in: Clinical neurophysiology Vol. 124; no. 11; p. e204
• Main Authors: Paci, C, Sobrini, S, Gobbato, R, D’Andreamatteo, G, Marzio, F. Di, Carboni, T, Sanguigni, S, Cinti, A, Groff, P, Urbano, V, Brandimarti, A, Costantini, L, Adrian, E, Ragno, M
• Format: Journal Article
• Language: English
• Published: Elsevier Ireland Ltd 01.11.2013
• Subjects: Neurology
• ISSN: 1388-2457; 1872-8952
• DOI: 10.1016/j.clinph.2013.06.094

Sudden unexpected death in epilepsy (SUDEP) represents a significant category of mortality in the population with chronic epilepsy. A consistent feature is that most of these deaths are unwitnessed. We report the case of an aged woman (85 years old) who was admitted in Department of Emergency. She was affected by an ovarian cancer complicated by septic shock. After about six hours she presented myoclonic jerks. The EEG recording was undertaken using a digital EbNeuro (BElight model), jasper montage, 7 μ V/mm amplitude, 30 HZ filter; 0.01 s. time constant. The ECG recording was obtained from monitor that registered all vital parameters (Body Temperature, Arterial Pressure, Oxygen Saturation, Cardiac Frequency). At the beginning of the EEG activity myoclonic jerks were registered with recurrent spike waves, after 20 s the patient presented generalised seizure (monitored by EEG with continuous diffused spike waves) and than suddenly she died. On EEG the seizure activity abruptly terminated and EEG became a flat line. At the beginning of the registration ECG registered tachycardia (110 Cardiac Frequency media value) and after the generalised seizure ECG rhythm rapidly changed and finally became a flat line. We hypothesized that death was due to SUDEP caused by septic shock.