ABSTRACT
How does one unravel the mystery of sudden unexpected death in persons with epilepsy (SUDEP)? Physicians must identify the persons with epilepsy who are at risk for SUDEP and use all available preventive medical and lifestyle measures, gleaning as much information as possible about the deaths of SUDEP victims by talking with medical examiners and coroners, reviewing autopsy reports (Schraeder et al. 2006, 2009, 2010), and obtaining verbal autopsy information provided by family members and close friends of the victim. The latter technique will help to fill in details missing from the physical autopsy or when no autopsy is done (Lathers and Schraeder 2009). It is also important to utilize in vivo and in vitro models of SUDEP to investigate risk factors, mechanisms, and preventive measures (Lathers et al. 2008; Scorza et al. 2008). Animal models allow us to focus on the details of one or more of the contributing mechanisms of risk for SUDEP. Use of experimental animals allows us to examine the contributing mechanisms of risk for SUDEP, with functional positive and negative feedback systems operating to maintain the normal physiology before experimental modifications, and then to study the effect of dysfunction induced by experimental manipulation of the intact physiological system. Techniques may be applied to various animal models to glean information about the molecular and genetic mechanisms of risks for SUDEP. The various animal models described in this chapter are relevant to the induction of cardiac arrhythmias by various mechanisms and shed light and provide understanding of the problem of sudden death, whether of cardiac or epileptogenic origin.
