OBJECTIVE: Most cases of sudden unexpected death in epilepsy (SUDEP) follow a 
seizure, and most deaths occur while people are in bed, presumably sleeping. 
Nocturnal seizures are reported to be a risk factor for SUDEP. People with 
nocturnal frontal lobe epilepsy (NFLE) have seizures predominantly or 
exclusively during sleep, often many times per night. The present study aimed to 
assess whether NFLE represents a high-risk condition for SUDEP.
METHODS: The present study retrospectively assessed the incidence of SUDEP in a 
cohort reconstructed from a dedicated database of consecutive patients referred 
to the Epilepsy and Sleep Centres of the Institute of Neurological Sciences of 
Bologna from 1980 to 2012 with: (1) a diagnosis of NFLE, (2) at least 90% of 
seizures during sleep, and (3) at least one-year of follow-up.
RESULTS: One hundred and three people were included. The median time from 
seizure onset to last observation was 26 years, equal to a follow-up of 2789 
person-years. One person died of SUDEP during the follow-up period. The 
incidence rate of SUDEP was 0.36 per 1000 person-years (95% CI 0.01 to 2.0).
CONCLUSIONS: The incidence of SUDEP in the participant population was not higher 
than the rates previously reported in prevalent epilepsy populations (0.4 to 2.3 
per 1000 person-years). The low prevalence of SUDEP might reflect the low 
occurrence of generalised tonic-clonic seizures in people with NFLE.