Reduce tonic-clonic seizures with antiseizure medications to lower the risk of sudden unexpected death in epilepsy

Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death in people with epilepsy. The greatest risk factor for SUDEP is the presence and frequency of tonic-clonic seizures, and therefore treatment with antiseizure medications (ASMs) to reduce seizure frequency and ideally achieve seizure freedom is key to reducing SUDEP risk. The use of polytherapy with multiple ASMs can have a protective effect against SUDEP. Promotion of medication adherence and encouragement of nocturnal supervision via the presence of roommates or the use of seizure detection devices can also aid in reducing the incidence of SUDEP.