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amplitude-derived parameters and tonic seizures have a marked increase in frequency. The
devices are worn on the biceps and multicenter studies are currently ongoing.

In the UK the NICE Guidelines state that tailored information and discussion between the
individual, family and/or carers and healthcare professional should take account of the small
but definite risk of SUDEP129. Several studies have suggested that the relatives of people who
died from SUDEP wished they had known of the risk of sudden death18,130. While it is not
certain that knowledge of the risks of epilepsy would necessarily prevent death, some
evidence suggests that observation, positioning and, where necessary, stimulation after a
seizure may protect against death. It is also likely that patients who know of the risks of
epilepsy might be more adherent to AED regimens and the avoidance of trigger factors, thus
reducing the frequency of seizures. In contrast, a cohort-controlled study of SUDEP from
Australia concluded that as there were no clear risk factors that were modifiable by practical
intervention, disclosure to the patient of the possibility of SUDEP was inappropriate131.

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