What criterion is associated with sudden unexpected death in epilepsy (SUDEP)?

The criterion associated with sudden unexpected death in epilepsy (SUDEP) being that there is no explained cause aligns with the understanding of SUDEP as a complex phenomenon. SUDEP refers to the unexpected, non-traumatic death of a person with epilepsy, where no clear explanation can be found, despite thorough investigation. This underscores a significant aspect of SUDEP — that it occurs without a specific cause attributed to the individual's seizures or any external factors.

In clinical practice and research, it is well recognized that SUDEP is more likely to occur in individuals with poorly controlled epilepsy, particularly those who experience generalized tonic-clonic seizures. However, even among those with frequent seizures, the specific mechanisms leading to SUDEP remain unclear, which is why the absence of an explained cause is a central criterion. This lack of clarity around the exact triggers or biological processes that may lead to SUDEP further emphasizes the need for enhanced monitoring and care in patients with epilepsy.