Paul L. Schraeder – författare

Sudden Unexpected Death in Epilepsy: Mechanisms and New Methods for Analyzing Risks builds on earlier works focusing on the clinical problem of sudden unexpected death in epilepsy (SUDEP). This book presents a methodology for identifying and classifying clusters of risks that lead to SUDEP. Developed over the last two years, the SUDEP Classification System and Risk Factor Cluster ID method will help to address gaps in our knowledge about the causes and possible prevention of this tragic complication.Exploring the interactions among the central and peripheral autonomic nervous systems and the cardiopulmonary systems, the book includes case studies of SUDEP, definite or probable, as well as near miss cases. It discusses how neurologists, emergency room physicians, and attending physicians can identify individuals at possible risk for SUDEP and lessen the chance of occurrence. Top medical professionals in the field detail the development of an international database of human cases and animal models of SUDEP and suggest how medical examiner and coroner offices can strengthen the database by providing information about incidences of SUDEP. In addition, the book describes related clinical and animal studies needed to classify risk factors for SUDEP victims.Understanding the risk factors and mechanisms underlying SUDEP will facilitate collaborative research in the laboratory, hospital, and clinic and lead to improved effectiveness of SUDEP prevention strategies.

Though it is one of the most common causes of death in epilepsy patients, SUDEP is still infrequently and even reluctantly named on autopsy reports. This under-reporting equates to a lack of attention and earnest investigation into the cause, predisposition, and prevention of SUDEP. There is as yet little effort to establish an actionable strategy in the mitigation of these potentially fatal arrhythmias. Expanding on the 1990 book Epilepsy and Sudden Death, edited by Lathers and Schraeder, Sudden Death in Epilepsy: Forensic and Clinical Issues reviews of the basic science of epilepsy as it relates to SUDEP. Clinical chapters study the sophisticated simultaneous ambulatory EKG and EEG telemetry and respiratory function monitoring of patients at risk for sudden death that will help identify cardiac, respiratory, and epileptogenic interactions involved. Chapters on animal models evaluate new data from studies that build on previously used models and emphasize that multiple models are needed to investigate the pathophysiology of SUDEP, to hypothesize about effective treatments, to develop pilot studies in persons with epilepsy, and to conduct confirmatory large-scale clinical trials.Contributions discuss the interaction between the central and peripheral autonomic nervous systems and the cardiopulmonary systems; proposed mechanistic factors in SUDEP; risk categories of arrhythmogenic, respiratory, and hypoxia related cardiac death; psychological, emotional, and stress related factors; the role of alcohol and drugs in seizures; and the potential mitigating properties of antiepileptic medication.Adopting a global, multidisciplinary focus to address the mystery of SUDEP, this important work provides clinicians, researchers, patients, and families with the knowledge to freely discuss the phenomenon and thereby discover the preventive treatment regimens to decrease the occurrence of SUDEP.