Sudden Unexpected Death in Epilepsy : Mechanisms and New Methods for Analyzing Risks

348 Pages·2015·40.87 MB·English

by  Claire M Lathers

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Mechanisms and New Methods for Analyzing Risks Mechanisms and New Methods for Analyzing Risks
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Sudden Unexpected Death in Epilepsy: Mechanisms and New Methods for Analyzing Risks builds
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on earlier works focusing on the clinical problem of sudden unexpected death in epilepsy (SUDEP).
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This book presents a methodology for identifying and classifying clusters of risks that lead to

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SUDEP. Developed over the last two years, the SUDEP Classification System and Risk Factor Cluster
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ID method will help to address gaps in our knowledge about the causes and possible prevention of
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this tragic complication.
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Exploring the interactions among the central and peripheral autonomic nervous systems and the E
cardiopulmonary systems, the book includes case studies of SUDEP, definite or probable, as well as C
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near miss cases. It discusses how neurologists, emergency room physicians, and attending physicians
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can identify individuals at possible risk for SUDEP and lessen the chance of occurrence. Top medical D
professionals in the field detail the development of an international database of human cases and
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animal models of SUDEP and suggest how medical examiner and coroner offices can strengthen
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the database by providing information about incidences of SUDEP. In addition, the book describes A
related clinical and animal studies needed to classify risk factors for SUDEP victims. T
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Understanding the risk factors and mechanisms underlying SUDEP will facilitate collaborative re-
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search in the laboratory, hospital, and clinic and lead to improved effectiveness of SUDEP preven-
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SUDDEN UNEXPECTED
DEATH IN EPILEPSY
Mechanisms and New Methods for Analyzing Risks

SUDDEN UNEXPECTED
DEATH IN EPILEPSY
Mechanisms and New Methods for Analyzing Risks
Edited by
Claire M. Lathers
Paul L. Schraeder
Jan E. Leestma
Braxton B. Wannamaker
Richard L. Verrier
Steven C. Schachter
Boca Raton London New York
CRC Press is an imprint of the
Taylor & Francis Group, an informa business
CRC Press
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© 2015 by Taylor & Francis Group, LLC
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Version Date: 20150211
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Dedications
To (DS), a 4-year-old boy with a history of nocturnal seizures who found hidden Christmas
presents, including the one he wanted most of all, a remote control car, 2 weeks before
Christmas. The next morning, he was found dead in bed. He and other victims of
SUDEP challenge all of us to find preventive measures as quickly as possible.
To Marcel J. Lajoy and Camille Lajoie and to Richard S. Lathers for their love, support,
and words of wisdom while completing this endeavor. To the memory of Schuyler W.
and Carol F. Lathers, who provided the engineering and liberal arts backgrounds and
education to support me as a scientist with an interest in autonomic questions related
to epilepsy, sudden death, cardiovascular pharmacology, and space flight.
Claire M. Lathers
To the lasting memory of my older brothers, “Boyd” (Robert Boyd Wannamaker)
and “Tommy” (Thomas Elliott Wannamaker, Jr.). Boyd and Tommy courageously
lived their lives with refractory epilepsy. Their lives ended too soon and because of
epilepsy, Boyd at 20 years by accident and Tommy at 31 years by SUDEP.
Braxton B. Wannamaker
To individuals with epilepsy, whose bravery challenges us all and
inspires our best work to address the SUDEP enigma.
Richard L. Verrier
To my patients who lost their lives to SUDEP and their families.
Steven C. Schachter

Contents
Foreword by Michael W. Bungo ..................................................................................................................................................xi
Foreword by Steven A. Koehler .................................................................................................................................................xiii
Foreword by Steven C. Schachter ...............................................................................................................................................xv
Preface.......................................................................................................................................................................................xvii
Acknowledgments ......................................................................................................................................................................xix
Editors ........................................................................................................................................................................................xxi
Contributors .............................................................................................................................................................................xxiii
Section i Forensics of SUDeP and cluster Risk Factor identification
Chapter 1 Mechanistic Mystery: Risk Factors in SUDEP .......................................................................................................3
Claire M. Lathers, Steven C. Schachter, Jan E. Leestma, Steven A. Koehler, H. Gregg Claycamp,
Braxton B. Wannamaker, and Paul L. Schraeder
Chapter 2 SUDEP: A Syndrome with Several If Not Many Potential Underlying Mechanisms ..........................................11
Claire M. Lathers, Steven C. Schachter, Jan E. Leestma, Steven A. Koehler, H. Gregg Claycamp,
Braxton B. Wannamaker, and Paul L. Schraeder
Chapter 3 Unraveling the Global Mystery of SUDEP ...........................................................................................................19
Claire M. Lathers, Steven C. Schachter, Jan E. Leestma, Steven A. Koehler, H. Gregg Claycamp,
Braxton B. Wannamaker, and Paul L. Schraeder
Chapter 4 Decision Analysis and Classification Methods for SUDEP Risk Factor Identification ........................................23
H. Gregg Claycamp, Claire M. Lathers, Paul L. Schraeder, and Braxton B. Wannamaker
Chapter 5 Forensic SUDEP Cluster Risk Factor Identifier Method ......................................................................................29
Claire M. Lathers, Jan E. Leestma, Steven C. Schachter, Steven A. Koehler, H. Gregg Claycamp,
Braxton B. Wannamaker, and Paul L. Schraeder
Chapter 6 Forensic Cases Classified as SUDEP Cluster Risk Factor Identifiers ...................................................................51
Claire M. Lathers, Paul L. Schraeder, and Steven A. Koehler
Chapter 7 How to and How Not to Use Cluster ID Method ..................................................................................................61
Paul L. Schraeder and Claire M. Lathers
Chapter 8 Clinical Cases Classified as SUDEP Cluster Risk Factor Identifiers ...................................................................65
Claire M. Lathers, Paul L. Schraeder, Steven C. Schachter, Richard L. Verrier, and
Braxton B. Wannamaker
Chapter 9 SUDEP: Continued Forensic Challenges ..............................................................................................................87
Jan E. Leestma and Claire M. Lathers
Chapter 10 A South Carolina Cohort of Epilepsy Patients ......................................................................................................95
Angela M. Malek and Braxton B. Wannamaker
vii
viii Contents
Chapter 11 Measuring the Incidence of SUDEP Using Forensic and National Data ............................................................103
Steven A. Koehler, Claire M. Lathers, and Paul L. Schraeder
Chapter 12 Risk Predictor: Individual SUDEP Risk Factor Cluster IDs ...............................................................................117
Claire M. Lathers, Steven C. Schachter, Braxton B. Wannamaker, and Jan E. Leestma
Chapter 13 Intracranial Pressure, Cerebral Edema, and Obstructive Sleep Apnea: A Risk Factor Cluster
for SUDEP? .........................................................................................................................................................121
Claire M. Lathers, Steven C. Schachter, Braxton B. Wannamaker, and Jan E. Leestma
Chapter 14 Neurocardiac Interactions in Sudden Unexpected Death in Epilepsy: Can Ambulatory
Electrocardiogram-Based Assessment of Autonomic Function and T-Wave Alternans
Help to Evaluate Risk? ........................................................................................................................................125
Richard L. Verrier and Steven C. Schachter
Chapter 15 Patient Management Using Cluster Risk Factor Identifiers ................................................................................139
Claire M. Lathers, Steven C. Schachter, Paul L. Schraeder, and Braxton B. Wannamaker
Chapter 16 Future Clinical and Animal Studies ...................................................................................................................145
Claire M. Lathers, Steven C. Schachter, and Paul L. Schraeder
Chapter 17 Animal Model Cluster IDs: Mechanisms and Risk Factors for SUDEP ............................................................157
Claire M. Lathers
Section ii SUDeP Animal Models: Mechanisms of Risks
Chapter 18 Sudden Death Animal Models to Study Nervous System Sites of Action for Disease and
Pharmacological Intervention .............................................................................................................................167
Claire M. Lathers
Chapter 19 A Characterization of the Lockstep Phenomenon in Phenobarbital-Pretreated Cats .........................................187
Jeffrey M. Dodd-O and Claire M. Lathers
Chapter 20 Relationship of the Lockstep Phenomenon and Precipitous Changes in Blood Pressure ...................................197
Amy Z. Stauffer, Jeffrey M. Dodd-O, and Claire M. Lathers
Chapter 21 Interspike Interval Histogram Characterization of Synchronized Cardiac Sympathetic Neural Discharge
and Epileptogenic Activity in the Electrocorticogram of the Cat .......................................................................207
Daniel K. O’Rourke and Claire M. Lathers
Section iii SUDeP Risk Mechanisms: Animal Models and clinical Studies
Chapter 22 Abnormal Brain Activity Triggers Long-Term Potentiation in Sympathetic Ganglia: Implication for
Sudden Death .......................................................................................................................................................219
Karim Alkadhi and Karem Alzoubi