Purpose of review: This review summarizes experimental and clinical research advances in the field of sudden unexpected death in epilepsy (SUDEP) over the past 3 years.
Recent findings: Novel animal models of SUDEP have been developed, highlighting the prevalence of peri-ictal respiratory dysfunction.The circumstances of SUDEP in genetic developmental and epileptic encephalopathies were found similar to those reported in more common epilepsies. Accordingly, most caregivers of patients with Dravet syndrome report using nocturnal monitoring devices and having averted critical incidents through such monitoring.Several prospective studies have identified novel SUDEP risk factors, including peri-ictal apnea, disrupted sleep homoeostasis, extratemporal epilepsies and elevated BMI. Retrospective analyses have additionally demonstrated associations between SUDEP and reduced polygenic risk scores for intelligence and longevityMultiple surveys highlight substantial gaps in SUDEP communication, with many people with epilepsy (PWE) and caregivers remaining insufficiently informed. This calls for action, given the accumulating evidence that optimizing seizure control is likely to reduce SUDEP risk.
Summary: Recent advances in SUDEP research further support a central role for seizure-related respiratory dysfunction. Greater efforts are needed to improve communication with PWE and caregivers regarding SUDEP risk factors, and to promote optimized monitoring and therapeutic strategies.
Keywords: animal models; communication; epilepsy; pathophysiology; prevention; risk factors; sudden unexpected death in epilepsy.
Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc.