Ictal central apnea as a predictor for sudden unexpected death in epilepsy

Stephan U. Schuele*, Mitra Afshari, Zahra S. Afshari, Michael P. Macken, Jorge Asconape, Lisa Wolfe, Elizabeth E. Gerard

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Epidemiological evidence associating ictal hypoventilation during focal seizures with a heightened risk for subsequent sudden unexpected death in epilepsy (SUDEP) is lacking. We describe a patient with temporal lobe epilepsy with two focal seizures recorded in the epilepsy monitoring unit that were associated with central apnea lasting 57 and 58. seconds. During these events, she demonstrated oxygen desaturation down to 68 and 62%. The patient subsequently died at home from autopsy-confirmed SUDEP. The family was not alerted of any seizure activity by the auditory alarm system in her room nor by sleeping in the adjacent room with open doors. This case emphasizes the fact that ictal hypoxia and SUDEP may occur in seizures without noticeable convulsive activity. The report gives credibility to the growing body of literature suggesting that epilepsies affecting the autonomic nervous system may predispose to SUDEP independent of the effects of a secondary generalized convulsion.

Original languageEnglish (US)
Pages (from-to)401-403
Number of pages3
JournalEpilepsy and Behavior
Issue number2
StatePublished - Oct 2011


  • Central apnea
  • Pulse oximetry
  • Sudden unexpected death in epilepsy
  • Video/EEG monitoring

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience


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