'Near miss' patient after the first seizure. from the pathophysiological mechanisms of SUDEP to the practical implications

Sudden unexpected death in epilepsy (SUDEP) is considered cause of many deaths in young people with epilepsy.We describe a 14-year-old male who experienced a prolonged tonic-clonic seizure, followed by respiratory insufficiency, and therefore requiring transfer to the intensive care unit.Magnetic resonance imaging (MRI) obtained 48 hours after the seizure revealed multiple and bilateral T2-signal hyperintensities. The followup MRIs (8 months) showed a partial resolution of the MRI abnormalities. As a “near miss” patient at the first seizure, this case offers several points of discussion.