C. Behr, M. A. Goltzene, G. Kosmalski, E. Hirsch, and P. Ryvlin, Epidemiology of epilepsy, Rev Neurol (Paris), vol.172, pp.27-36, 2016.

D. J. Thurman, D. C. Hesdorffer, and J. A. French, Sudden unexpected death in epilepsy: Assessing the public health burden, Epilepsia, vol.55, pp.1479-1485, 2014.

P. Ryvlin, L. Nashef, and S. D. Lhatoo, Incidence and mechanisms of cardiorespiratory arrests in epilepsy monitoring units (MORTEMUS): a retrospective study, Lancet Neurol, vol.12, pp.966-977, 2013.
URL : https://hal.archives-ouvertes.fr/hal-00919412

C. Harden, T. Tomson, and D. Gloss, Practice guideline summary: Sudden unexpected death in epilepsy incidence rates and risk factors: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the, Neurology, vol.88, pp.1674-1680, 2017.

C. Verducci, F. Hussain, and E. Donner, SUDEP in the North American SUDEP Registry: The full spectrum of epilepsies, Neurology, vol.93, pp.227-236, 2019.

E. J. Donner, C. R. Smith, and O. C. Snead, Sudden unexplained death in children with epilepsy, Neurology, vol.57, pp.430-434, 2001.

S. D. Lhatoo, M. Nei, and M. Raghavan, Nonseizure SUDEP: Sudden unexpected death in epilepsy without preceding epileptic seizures, Epilepsia, vol.57, pp.1161-1168, 2016.

L. Nashef, F. Walker, P. Allen, J. W. Sander, S. D. Shorvon et al., Apnoea and bradycardia during epileptic seizures: relation to sudden death in epilepsy, J Neurol Neurosurg Psychiatry, vol.60, pp.297-300, 1996.

M. Berthon-jones and C. E. Sullivan, Ventilation and arousal responses to hypercapnia in normal sleeping humans, J Appl Physiol, vol.57, pp.59-67, 1984.

G. F. Buchanan, Impaired CO2-Induced Arousal in SIDS and SUDEP, Trends Neurosci, vol.42, pp.242-250, 2019.

L. P. Sowers, C. A. Massey, B. K. Gehlbach, M. A. Granner, and G. B. Richerson, Sudden unexpected death in epilepsy: Fatal post-ictal respiratory and arousal mechanisms, Respir Physiol Neurobiol, vol.189, pp.315-323, 2013.

Q. Zhan, G. F. Buchanan, and J. E. Motelow, Impaired Serotonergic Brainstem Function during and after Seizures, J Neurosci, vol.36, pp.2711-2722, 2016.

A. Ali, S. Wu, and N. P. Issa, Association of sleep with sudden unexpected death in epilepsy, Epilepsy Behav, vol.76, pp.1-6, 2017.

A. Bozorgi and S. D. Lhatoo, Seizures, Cerebral Shutdown, and SUDEP: SUDEP -A Perfect Storm, Epilepsy Curr, vol.13, pp.236-240, 2013.

S. D. Lhatoo, H. J. Faulkner, K. Dembny, K. Trippick, C. Johnson et al., An electroclinical case-control study of sudden unexpected death in epilepsy, Ann Neurol, vol.68, pp.787-796, 2010.

J. Kuo, W. Zhao, C. Li, J. D. Kennedy, and M. Seyal, Postictal immobility and generalized EEG suppression are associated with the severity of respiratory dysfunction, Epilepsia, vol.57, pp.412-417, 2016.

S. Rajakulendran and L. Nashef, Postictal Generalized EEG Suppression and SUDEP: A Review, J Clin Neurophysiol, vol.32, p.7, 2015.

J. S. Meyer, H. D. Portnoy, . Post-epileptic, and . Paralysis-a, CLINICAL AND EXPERIMENTAL STUDY. Brain, vol.82, pp.162-185, 1959.

V. Alexandre, B. Mercedes, and L. Valton, Risk factors of postictal generalized EEG suppression in generalized convulsive seizures, Neurology, vol.85, pp.1598-1603, 2015.
URL : https://hal.archives-ouvertes.fr/hal-02344883

S. Meyer and M. Strittmatter, Autonomic changes with seizures correlate with postictal EEG suppression, Neurology, vol.80, pp.1538-1539, 2013.

M. Poh, T. Loddenkemper, and C. Reinsberger, Autonomic changes with seizures correlate with postictal EEG suppression, Neurology, vol.78, pp.1868-1876, 2012.

R. J. Lamberts, S. Laranjo, and S. N. Kalitzin, Postictal generalized EEG suppression is not associated with periictal cardiac autonomic instability in people with convulsive seizures: PGES and Cardiac Autonomic Instability, Epilepsia, vol.54, pp.523-529, 2013.

C. Sevcencu and J. J. Struijk, Autonomic alterations and cardiac changes in epilepsy: Cardiac Effects in Epilepsy, Epilepsia, vol.51, pp.725-737, 2010.

B. Moseley, L. Bateman, J. J. Millichap, E. Wirrell, and C. P. Panayiotopoulos, Autonomic epileptic seizures, autonomic effects of seizures, and SUDEP, Epilepsy Behav, vol.26, pp.375-385, 2013.

M. Stewart, An explanation for sudden death in epilepsy (SUDEP), J Physiol Sci, vol.68, pp.307-320, 2018.

P. A. Lotufo, L. Valiengo, I. M. Benseñor, and A. R. Brunoni, A systematic review and meta-analysis of heart rate variability in epilepsy and antiepileptic drugs: HRV in Epilepsy, Epilepsia, vol.53, pp.272-282, 2012.

R. K. Goit, S. K. Jha, and B. N. Pant, Alteration of cardiac autonomic function in patients with newly diagnosed epilepsy, Physiol Rep, vol.4, p.12826, 2016.

R. E. Kleiger, P. K. Stein, and J. T. Bigger, Heart Rate Variability: Measurement and Clinical Utility, Ann Noninvasive Electrocardiol, vol.10, pp.88-101, 2005.

R. Surges, C. Henneberger, P. Adjei, C. A. Scott, J. W. Sander et al., Do alterations in inter-ictal heart rate variability predict sudden unexpected death in epilepsy?, Epilepsy Res, vol.87, pp.277-280, 2009.

K. A. Myers, L. E. Bello-espinosa, and J. D. Symonds, Heart rate variability in epilepsy: A potential biomarker of sudden unexpected death in epilepsy risk, Epilepsia, vol.59, pp.1372-1380, 2018.

L. A. Allen, S. B. Vos, and R. Kumar, Cerebellar, limbic, and midbrain volume alterations in sudden unexpected death in epilepsy, Epilepsia, vol.60, pp.718-729, 2019.

A. Somani, A. Zborovschi, and Y. Liu, Hippocampal morphometry in sudden unexpected death in epilepsy, Neurology. Epub, 2019.

L. A. Allen, R. M. Harper, S. Lhatoo, L. Lemieux, and B. Diehl, Neuroimaging of Sudden Unexpected Death in Epilepsy (SUDEP): Insights From Structural and Resting-State Functional MRI Studies, Front Neurol, vol.10, p.185, 2019.

I. Aiba and J. L. Noebels, Spreading depolarization in the brainstem mediates sudden cardiorespiratory arrest in mouse SUDEP models, Sci Transl Med, vol.7, pp.282-328, 2015.

K. A. Myers, S. Sivathamboo, and P. Perucca, Heart rate variability measurement in epilepsy: How can we move from research to clinical practice?, Epilepsia, vol.59, pp.2169-2178, 2018.

V. Novak, A. L. Reeves, P. Novak, P. A. Low, and F. W. Sharbrough, Time-frequency mapping of R-R interval during complex partial seizures of temporal lobe origin, J Auton Nerv Syst, vol.77, pp.195-202, 1999.

M. Jeanne, R. Logier, J. De-jonckheere, and B. Tavernier, Validation of a graphic measurement of heart rate variability to assess analgesia/nociception balance during general anesthesia, Annu Int Conf IEEE Eng Med Biol Soc, 2009.

M. N. Minneapolis, , pp.1840-1843, 2009.

, Task Force of The European Society of Cardiology and The North AmericanSociety of Pacing and Electrophysiology. Heart rate variability: Standards of measurement, physiological interpretation, and clinical use, Eur Heart J, vol.17, p.28, 1996.

D. J. Ewing, C. N. Martyn, R. J. Young, and B. F. Clarke, The Value of Cardiovascular Autonomic Function Tests: 10 Years Experience in Diabetes, Diabetes Care, vol.8, pp.491-498, 1985.

G. Assenza, O. Mecarelli, and M. Tombini, Hyperventilation induces sympathetic overactivation in mesial temporal epilepsy, Epilepsy Res, vol.110, pp.221-227, 2015.

E. Saetre and M. Abdelnoor, Incidence rate of sudden death in epilepsy: A systematic review and meta-analysis, Epilepsy Behav, vol.86, pp.193-199, 2018.

L. Nashef, D. R. Fish, J. W. Sander, and S. D. Shorvon, Incidence of sudden unexpected death in an adult outpatient cohort with epilepsy at a tertiary referral centre, J Neurol Neurosurg Psychiatry, vol.58, pp.462-464, 1995.

O. Devinsky, D. C. Hesdorffer, D. J. Thurman, S. Lhatoo, and G. Richerson, Sudden unexpected death in epilepsy: epidemiology, mechanisms, and prevention, Lancet Neurol, vol.15, pp.1075-1088, 2016.

M. S. Cooper, A. Mcintosh, and D. E. Crompton, Mortality in Dravet syndrome, Epilepsy Res, vol.128, pp.43-47, 2016.

L. Nashef, E. L. So, P. Ryvlin, and T. Tomson, Unifying the definitions of sudden unexpected death in epilepsy: Unifying the Definitions of SUDEP, Epilepsia, vol.53, pp.227-233, 2012.

S. Akselrod, D. Gordon, F. Ubel, D. Shannon, A. Berger et al., Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control, Science, vol.213, pp.220-222, 1981.

M. Toichi, T. Sugiura, T. Murai, and A. Sengoku, A new method of assessing cardiac autonomic function and its comparison with spectral analysis and coefficient of variation of R-R interval, J Auton Nerv Syst, vol.62, pp.79-84, 1997.

L. Baysal-kirac, N. G. Serbest, and E. ?ahin, Analysis of heart rate variability and risk factors for SUDEP in patients with drug-resistant epilepsy, Epilepsy Behav, vol.71, pp.60-64, 2017.

J. L. Novak, P. R. Miller, D. Markovic, S. K. Meymandi, and C. M. Degiorgio, Risk Assessment for Sudden Death in Epilepsy: The SUDEP-7 Inventory. Front Neurol [online serial, vol.6, 2015.

N. Odom and L. M. Bateman, Sudden unexpected death in epilepsy, periictal physiology, and the SUDEP-7 Inventory, Epilepsia, vol.59, pp.157-160, 2018.

A. Galli and F. Lombardi, Heart rate variability regression and risk of sudden unexpected death in epilepsy, Med Hypotheses, vol.99, pp.49-52, 2017.

G. Rauscher, A. C. Degiorgio, P. R. Miller, and C. M. Degiorgio, Sudden unexpected death in epilepsy associated with progressive deterioration in heart rate variability, Epilepsy Behav, vol.21, pp.103-105, 2011.

N. Lacuey, B. Zonjy, and W. Theerannaew, Left-insular damage, autonomic instability, and sudden unexpected death in epilepsy, Epilepsy Behav, vol.55, pp.170-173, 2016.

N. Barot and M. Nei, Autonomic aspects of sudden unexpected death in epilepsy (SUDEP), Clin Auton Res, vol.29, pp.151-160, 2019.

W. P. Cheshire, Highlights in clinical autonomic neurosciences: Sudden unexpected death in epilepsy, Auton Neurosci, vol.179, pp.5-8, 2013.

W. Szurhaj, A. Troussière, and R. Logier, Ictal changes in parasympathetic tone: Prediction of postictal oxygen desaturation, Neurology, vol.85, pp.1233-1239, 2015.
URL : https://hal.archives-ouvertes.fr/hal-01246759

L. M. Bateman, C. Li, and M. Seyal, Ictal hypoxemia in localization-related epilepsy: analysis of incidence, severity and risk factors, Brain, vol.131, pp.3239-3245, 2008.

T. Tomson, R. Surges, R. Delamont, S. Haywood, and D. C. Hesdorffer, Who to target in sudden unexpected death in epilepsy prevention and how? Risk factors, biomarkers, and intervention study designs, Epilepsia, vol.57, pp.4-16, 2016.

R. Schulz, C. G. Bien, and T. W. May, Decreasing SUDEP incidence in a tertiary epilepsy center between 1981 and 2016: Effects of better patient supervision, Epilepsy Behav, vol.92, pp.1-4, 2019.

. Vii, . Liste, ?. Abreviations-?-csi-:-cardiac-sympathetic-index, ?. Ctcg-:-crise-tonico-clonique-généralisée, ?. Ecg-:-electro-encéphalogramme et al., Low Frequencies ? PGES : Postictal Generalized EEG suppression ? RMSSD : Root Mean Square of the Successive Differences ? ROC : Receiver Operating Characteristic ? RSME : Réseau Sentinelle Mortalité Epilepsie ? SDNN : Standard Deviation Normal to Normal ? SNA : Système Nerveux Autonome ? SNV : Stimulateur du Nerf Vague ? SUDEP : Sudden unexpected Death in Epileptic Patient ? VFC : Variabilité de la Fréquence Cardiaque ? VLF : Very Low Frequencies Fonction autonomique cardiaque chez les patients épileptiques décédés de SUDEP, une étude cas-témoin Résumé Mots-clés : Rythme cardiaque, Système Nerveux Autonome, Epilepsie Pharmacoresistante, Biomarqueur, Mort Subite, Hyperventilation Introduction : La SUDEP (Sudden Unexpect Death in Epileptic Patient) est une complication tragique dans la population épileptique. Le mécanisme supposé est une dysautonomie postcritique importante conduisant à une défaillance cardio-respiratoire. Nous supposons que les patients décédés de SUDEP présentent une altération de leur réponse autonome, Groupe du Registre Epilepsie National ? HF : High Frequencies ? HFVI : High Frenquencies Variability Index ? HPN : Hyperpnée ? ILAE : International League Against Epilepsy ? LF

M. Matériel, Les patients inclus devaient être décédés d'une SUDEP définie ou probable et avoir un tracé EEG disponible récent avec un ECG interprétable, comprenant deux minutes de repos en dehors de toute stimulation et une épreuve d'hyperpnée (HPN), Nous avons mené une étude cas témoin rétrospective, multicentrique, faisant intervenir les CHU d'Amiens