成年人癫痫猝死(附两例病例报告)

目的 探讨成年人癫痫猝死（sudden unexpected death in epilepsy，SUDEP）的临床表现及可能发生的机制。方法回顾性分析2例成年人SUDEP的临床资料并复习有关文献。结果2例成年男性患者均在数分钟内发生突然死亡，均为特发性全面性强直-阵挛发作类型；均为长期服用抗痫药物且癫痫控制不良。1例在睡眠中死亡，另1例在午饭后死亡。结论成年人SUDEP的发生机制可能为：心律失常，神经源性肺水肿和中枢性呼吸抑制。强直-阵挛性发作、联合用药及癫痫控制不良是SUDEP的危险因素。较好地控制强直-阵挛发作是减少SUDEP的有效措施。

Sudden unexpected death in epilepsy

Objective To investigate the clinical features and mechanism of SUDEP.Methods Retrospective studies the clinical features in 2 adult cases that died of SUDEP.Results Two patients with general tonic-clonic seizures were died suddenly in minutes.One died in sleep and another died after lunch.They had all been taking antiepileptic drugs for long time,but the medicine could not control the seizures completely.Conclusion SUDEP is a major cause of morthality for patients with epilepsy.Three mechanisms have been proposed for SUDEP: cardiac arrhythmia,neurogenic pulmonary oedema and central apnoea.Possible risk factors include: tonic-clonic seizures,multiple antiepileptic drugs therapy and poor seizure control.The risk of SUDEP can decreased by aggressive treatment of tonic-clonic seizures with as few antiepileptic drugs as necessary to achieve complete control.