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SUDEP risk counselling — SCE Neurology MCQ

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HardEpilepsySUDEP risk counsellingSCE Neurology

A 28-year-old with focal epilepsy has four nocturnal focal-to-bilateral tonic-clonic seizures each year, usually after missed medication. He lives and sleeps alone. Which intervention most directly addresses his modifiable SUDEP risk profile?

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

Reveal the answer and explanation

Correct answer: D — Discuss SUDEP while optimising seizure control, adherence and nocturnal safety

Explanation lettering: C = shown as A · D = shown as C · E = shown as D · A = shown as E

A delays a discussion NICE recommends from diagnosis and misses recognised risks. B does not address the dominant modifiable factors. C reverses the association of sleeping alone with risk. D has no role as a substitute for seizure control. E is correct: uncontrolled tonic-clonic seizures and non-adherence are major modifiable risks, while living or sleeping alone supports discussing feasible night-time supervision or monitoring through shared decision-making.

Reference: NICE NG217: reducing epilepsy-related death including SUDEP: https://www.nice.org.uk/guidance/ng217/chapter/10-Reducing-the-risk-of-epilepsy-related-death-including-SUDEP