Brugada Syndrome in Epilepsy Patients at Risk of Sudden Unexpected Death: A Cross-Sectional Study

Sudden unexpected death in epilepsy (SUDEP) remains a significant concern, with potential links to cardi-ac arrhythmias such as Brugada syndrome (BrS). This study investigated the prevalence of BrS in epilep-sy patients at risk of SUDEP. A cross-sectional study was conducted at Shahid Beheshti Hospital, Kashan, Iran, involving 150 participants divided into three groups: (1) epilepsy patients at high SUDEP risk, (2) epilepsy patients at low SUDEP risk, and (3) non-epileptic controls. SUDEP risk was assessed using the SUDEP-7 inventory, and BrS was diagnosed via electrocardiogram (ECG). Statistical analyses included chi-square, t-tests, and ANOVA (SPSS v.22). BrS was identified in two high-risk and one low-risk epilepsy patient, with no significant prevalence difference between groups (P > 0.05). Only one patient on anticon-vulsants had BrS (P = 0.99). No associations were found with gender, age, or specific antiepileptic drugs (e.g., sodium valproate, phenobarbital). Phenytoin—a sodium channel blocker—was absent in the cohort, aligning with prior evidence of its proarrhythmic potential in BrS. While BrS prevalence was higher in high-SUDEP-risk epilepsy patients, the difference was not statistically significant. Demographic factors (age, gender) and anticonvulsant use did not influence BrS occurrence. Larger multicenter studies and provocative testing (e.g., flecainide challenge) are recommended to clarify this association.