Background: This study reports 13 SUDEP cases in the North American SUDEP Registry with both psychogenic nonepileptic (PNES) and epileptic (ES) seizures among a consecutive series of 231 cases (excluding epileptic encephalopathies).
Results: On average, cases of PNES+ES died at a younger age (23 ± 11 years) than the ES-only cohort (30 ± 14 years), and died an average of 3 years after PNES diagnosis. The research team found no statistically significant confounding cardiac, respiratory, or psychiatric comorbidities and equal rates of anti-seizure medication adherence, although there was a trend for higher rates of psychiatric disorders in the PNES group.
Significance: Researchers state these findings confirm that patients with comorbid epileptic seizures (ES) and psychogenic nonepileptic seizures (PNES) can die from SUDEP and that there may be a high-risk period after the diagnosis of PNES is made in patents with comorbid ES. Such patients should be closely monitored and provided with coordinated care of both their epilepsy and psychiatric disorder(s).