National Network for the Study of Predictors and Prevention of Sudden Unexpected Death in Drug-resistant Partial Epilepsies

Study Overview
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Brief Summary
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Sudden unexpected death in epilepsy (SUDEP) is the main concern of professionals and patient associations involved in epilepsy. These represent a priority for the Ligue Française Contre l'Epilepsie (LFCE). The SUDEP affect primarily young adults, between 18 and 40 years, suffering from epilepsy uncontrolled by medication. In this population of close to 100,000 people in France, the incidence of SUDEP is estimated at 0.5%, or nearly 500 deaths per year. It is clear that the majority of these deaths occur in the immediate consequences of a crisis.. Investigators suppose that a causal link exists between the occurrence of a SUDEP and a per / post-critic decline of SpO2 below 80 % (75 % of cases, 20 % of controls).The constitution of a cohort of 1500 patients clinically well described and a national database will allow other ambitious projects in a speciality where French centres benefit from a unique knowledge, recognized by their foreign colleagues, but underexploited to date. The LFCE (Ligue Française Contre l'Epilepsie) is developing structuring actions to facilitate such exploratory studies for the next two years. The high death rate which characterizes the drug-resistant partial epilepsies and, in particular, Sudden Unexpected Deaths in Epilepsy (SUDEP) represents the main axis of research for the Ligue Française Contre l'Epilepsie (LFCE) as well as for associations of epileptic patients and the European representatives of the international league against epilepsy ( ILAE). Today, SUDEP occurrences cannot be anticipated. Patients can't be warned against SUDEP. Although the SUDEP physiopathology remains uncertain, many elements plead for the essential role of a per-and post-critic apnea (central or obstructive). Investigators observe that about 20 % of the patients admitted in a EEG-video monitoring - EEG unit for recording their crisis are going to present experience an per / post-critic severe apnea, severe per / post-critic enough to have induce a SpO2 < 80 % decrease. However, today, no study has estimated the link relation between the arisen occurrence of such apneas and the later risk of SUDEP.

Official Title
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National Network for the Study of Predictors and Prevention of Sudden Unexpected Death in Drug-resistant Partial Epilepsies

Conditions
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Drug-resistant Partial Epilepsy

Intervention / Treatment
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* Other: video-EEG


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients suffering from drud-resistant partial epilepsy ; Patients who are at least 15 years ; Patients for whom a video-EEG monitoring of their seizures was scheduled as part of a pre-surgical assessment ; Patients having a registration number in the RNIP (Répertoire National d'Identification des Personnes Physiques) or a Social Security number Patients who have given their written consent ; Patients with a social security Exclusion Criteria: Patients under 15 years Patients without drug-resistant partial epilepsy Patients without a registration number in the RNIP (Répertoire National d'Identification des Personnes Physiques) or a Social Security number) Patient without a consent signed

Ages Eligible for Study
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Minimum Age: 15 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| video-EEG<br>Patients suffering from drug-resistant partial epilepsy for whom a video-EEG monitoring of their seizures was scheduled as part of pre-surgical assessment | Other: video-EEG<br>* Registration of seizures during video-EEG<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients with SpO2 < 80% decreases during the EEG-video monitoring | To establish a relation between the occurence of SpO2 < 80% decreases during a EEG-video monitoring and the later risk of SUDEP. | 6 and a half months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frequence of other known potential risk factors (composite measure : presence rate of each risk factor in SUDEP measured as percentage) | To test the other potential risk factors of known or still under exploration SUDEPs or still in study (area of the beginning of epilepsy, the abnormalities of sinusal variability). Known potential risk factors are : etiology; epilepsy starting age and duration; crisis frequency in the last 12 months; crisis frequency of secondarly generalized crisis in the last 12 months; presence of nocturnal crisis in the last 12 months; number of concomitant traitments; carbamapezin treatment, Body Mass Indice, sleep apnea syndrome, mood disorder, life qualitity, treatment side effects. | 6 and a half months | 
| Allelic frequency of genes involved in epileptogenesis (measured as percentage) | Evaluation of the genetic polymorphism of the monoaminergic system or of genes involved in the early epilepsy stage mechanisms of early stages of epilepsy. | 6 and a half months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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epilepsy, SUDEP, SpO2