Prone sleeping and SUDEP risk: The dynamics of body positions in nonfatal convulsive seizures

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• 作者：Sharon Shmuely^a ; ^b ; ^c ; Rainer Surges^d ; Josemir W. Sander^a ; ^b ; ^c ; Roland D. Thijs^a ; ^b ; ^c ; ^e ; ^{rthijs@sein.nl" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Sudden unexpected death in epilepsy (SUDEP) ; Epilepsy ; Semiology ; Prone position
• 刊名：Epilepsy & Behavior
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：62
• 期：Complete
• 页码：176-179
• 全文大小：334 K

文摘

Most victims of sudden unexpected death in epilepsy (SUDEP) are found prone with signs suggestive of an unwitnessed convulsive seizure (CS). Prone sleeping has been proposed as a risk factor for SUDEP. Little is known, however, about the change of body position during the course of CSs.

Methods

We retrospectively reviewed video-EEG data and assessed body positions during the course of CSs, until there was a physical interaction by nursing staff with the subject.

Results

We identified 180 CSs in 90 individuals. In 16 of the 180 CSs (9%), the subject started in or turned to the prone position. Of the seven CSs that started in the prone position, three turned to a lateral position during the CS. In 13 CSs, the subject was in prone position at time of nursing intervention; nine (69%) of these started in a nonprone position.

Discussion

Our data suggest that the prone position occurs infrequently in closely supervised nonfatal CSs, a notable contrast to the number of victims of SUDEP found prone. Whether prone sleeping prior to CSs increases SUDEP risk, however, remains speculative, as body position during the course of a CS appeared to be dynamic.