Neurological conditions and sudden death

Sudden death does occur in a number of acute catastrophic neurological diseases or chronic neurological illnesses with acute decompensation. 1 The term rapid death, rather than sudden death, may be more appropriate in characterizing the mode of death in these conditions, because deteriorating vital signs are often observed over minutes or hours prior to death. In contrast, sudden cardiac or respiratory arrest without warning is a hallmark of the condition of sudden unexplained or unexpected death in epilepsy (SUDEP). Sudden unexplained or unexpected death in epilepsy occurs in settings of normal daily activities, and the death can be correctly characterized as unexplained when an autopsy discloses no cause for the death. On the other hand, rapid death in acute neurological conditions such as large cerebral infarcts or head trauma, though unexpected by family and caregivers, cannot be said to be totally unexplained.