Several potential pathophysiologic phenomena, including “cerebral shutdown,” are postulated to be responsible for SUDEP. Since the evidence for a seizure-related mechanism is strong, a poor understanding of the physiology of human seizure termination is a major handicap. However, rather than a failure of a single homeostatic mechanism, such as postictal arousal, it may be a “perfect storm” created by the lining up of a several factors that lead to death.
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