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SUDEP Risk Factors — SCE Neurology MCQ

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HardEpilepsy & Seizure DisordersSUDEP Risk FactorsSCE Neurology

A 32-year-old woman with well-controlled epilepsy is seen for pre-conception counselling. Her neurologist discusses the risk of sudden unexpected death in epilepsy (SUDEP). Which factor most strongly increases SUDEP risk?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Frequent generalised tonic-clonic seizures, particularly during sleep and without supervision

The best answer is “Frequent generalised tonic-clonic seizures, particularly during sleep and without supervision”. NICE bases epilepsy diagnosis and treatment on seizure type, syndrome, recurrence risk, comorbidity, pregnancy potential and medicine harms; typical provoked seizures are managed by correcting the provoking cause. The alternatives “Rare focal-aware sensory seizures without convulsions, after specialist assessment”, “A normal interictal EEG despite established epilepsy, when the phenotype supports it”, “Use of a single antiseizure medicine at standard dose”, “Long duration of seizure freedom with reliable adherence” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: NICE NG217 epilepsy recommendations: https://www.nice.org.uk/guidance/ng217/chapter/Recommendations