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Neurologists and pediatricians often make clinical recommendations without consideration of sudden unexplained death in epilepsy (SUDEP), do not consistently inform parents of the risks of SUDEP among their children with epilepsy, and often postpone facing the reality of SUDEP risk until their patients reach adulthood.1 On casual inspection, the literature reviewed in a recent guideline might reinforce some clinicians' practice of delaying these unpleasant SUDEP-related decisions and discussions until adulthood.2 Until recently, the reported SUDEP rate among children during their first 18 years of life (1 per 4,500/y) was about one-fourth to one-fifth that of the risk of SUDEP among adults with epilepsy (1 per 1,000/y).2 Yet the emerging evidence regarding SUDEP incidence among children is changing, especially among children with intractable epilepsy, and should prompt a change in physician practice and generate more research.
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