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MORTEMUS MORT ality in E pilepsy M onitoring U nit S tud y. USING IN-HOSPITAL PRE-SURGICAL MONITORING DATA TO ASSESS RISKS, MECHANISMS AND RISK FACTORS OF SUDDEN UNEXPECTED DEATH IN EPILEPSY (SUDEP) Proposal for an ILAE sponsored European study Philippe Ryvlin, Lyon
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MORTEMUSMORTality in Epilepsy Monitoring Unit Study USING IN-HOSPITAL PRE-SURGICAL MONITORING DATA TO ASSESS RISKS, MECHANISMS AND RISK FACTORS OF SUDDEN UNEXPECTED DEATH IN EPILEPSY (SUDEP) Proposal for an ILAE sponsored European study Philippe Ryvlin, Lyon Torbjörn Tomson, Stockholm
Why Epilepsy Surgery Patients? • Population with highest risk • Population/situation with most and best data
Why collaboration? • Because SUDEP is a rare event • Broad collaboration is the only way to collect sufficient numbers
MORTEMUS Objectives • To quantify the risk of death, SUDEP, and “near SUDEP”, in patients with drug resistant partial epilepsy who have undergone long-term video-EEG monitoring • To gather up to 20 cases of SUDEP / “near SUDEP” for whom concomitant video, EEG and EKG data will be available • To provide evidence regarding the respective role of cardiac vs. respiratory dysfunctions in the pathophysiology of SUDEP • To identify risk factors for SUDEP in patients with refractory epilepsy
Objectives continued • To evaluate the feasibility and rationale for launching a large scale European prospective study that aims to confirm the above retrospective data, and also to determine whether heart rate variability parameters can predict the risk of SUDEP
MORTEMUS Methods • To establish a network of collaborating epilepsy surgery centres in Europe, aiming at in total 3-4000 patient years of monitoring during the past 10 years • Distribution of questionnaire regarding SUDEP or near-SUDEP cases during monitoring in these units • Centralised analysis of all data (EEG, ECG, video etc) from SUDEP/near-SUDEP cases for a descriptive study • Case-control study of SUDEP/near-SUDEP cases vs. Non-SUDEP epilepsy controls from the same monitoring unit