Aug 2026· Frontiers in Neurology· Vol 17· 0 citations· 59 references
Medicine
TL;DR
This review provides a comprehensive synthesis of the SUDEP pathophysiological framework, aiming to bridge the gap between retrospective clinical observation and proactive precision medicine, and outlines a multidisciplinary approach to transforming SUDEP into a more predictable and preventable clinical entity.
Abstract
Sudden Unexpected Death in Epilepsy (SUDEP) represents a leading cause of epilepsy-related mortality, reflecting a severe disruption of systemic physiology that remains challenging to address using standard clinical protocols. Although generalized tonic–clonic seizures (GTCS) and pharmacoresistance are established risk indicators, current clinical risk stratification frequently lacks the predictive granularity required to anticipate individual cardiorespiratory collapse. This review provides a comprehensive synthesis of the SUDEP pathophysiological framework, aiming to bridge the gap between retrospective clinical observation and proactive precision medicine. We delineate a translational framework focused on the intrinsic biological susceptibility of the neuro-cardiac axis, particularly the genetic “dual pathology” of channelopathies and structural cardiac remodeling. Furthermore, we evaluate the transition from reactive risk identification toward multimodal “digital phenotyping” leveraging artificial intelligence. Finally, we assess the developmental trajectory of “secondary prevention” strategies, such as automated neurostimulation, designed to interrupt the terminal cascade. By integrating genomic vulnerability with emerging preventative technologies, this review outlines a multidisciplinary approach to transforming SUDEP into a more predictable and preventable clinical entity.
This work proposes a threshold management framework for DRE, built on a revised reservoir model, and translates it into three structural priorities: mechanistic phenotyping to stratify patients by pathophysiological domain, dual-mechanism drug development, and trial designs suited to multicomponent, context-dependent interventions.
Alexander Trofimov, Ksenia Shcherbakova, Alexander Schwarz et al.· International Journal of Mol...· 0 citations
Epilepsy is increasingly recognized as a multiscale network disorder rather than solely a condition of neuronal hyperexcitability, and the coordinated use of complementary human-relevant platforms may help incorporate multiscale mechanistic insights into therapeutic development and evaluation, narrow persistent translational gaps, and support more predictive and mechanism-informed treatment strategies.
Wonseok Chang, Amy Seomin Kwak, Seung-Ho Han et al.· Pharmaceutics· 0 citations
The review emphasizes the need for further interdisciplinary collaboration to accelerate the translation of these findings into clinical practice, ultimately improving outcomes and quality of life for people with epilepsy.
Mirte Scheper, Zining Liu, A. Galanopoulou et al.· Epilepsia· 0 citations
This review synthesizes advances in neuroimmunology, clinical phenotyping, diagnostics, immunomodulatory and antiseizure therapies, neuromodulation, and patient and family centered outcomes, and outlines future directions focused on biomarker-driven precision medicine, disease-modifying strategies, and interdisciplinary care models.
Alica M. Goldman, Nora Wong, A. Vezzani et al.· Epilepsy Currents· 0 citations
Sepsis-induced cardiomyopathy (SIC) is an acute reversible myocardial dysfunction complicating sepsis. With impaired cardiac systolic and diastolic function, it greatly increases the risk of multiple organ failure and mortality in septic patients. This systematic review outlines the overall research landscape of SIC, including pathological mechanisms, epidemiological profiles, updated diagnostic systems and innovative therapeutic strategies, as well as existing challenges and future research priorities. Five major pathological pathways jointly mediate SIC progression, and its prevalence and mortality differ substantially across regions, populations and infectious pathogens. The diagnostic framework has been updated to a multi-dimensional evaluation system, and emerging imaging techniques and combined biomarker panels have greatly improved early diagnostic performance. Therapeutic concepts have transformed from conventional symptomatic care to mechanism-oriented precise intervention, with multiple new therapies and intelligent medical tools applied clinically. At present, inconsistent diagnostic criteria, insufficient specific medications and unbalanced medical resources worldwide hinder clinical management. Future studies aim to standardize diagnostic criteria, explore molecular mechanisms, accelerate the clinical application of targeted drugs, and popularize advanced technologies in under-resourced areas to improve patient outcomes.
Nai-hong Zhang, Neng Wang, Jiawen He et al.· Frontiers in Cardiovascular...· 0 citations