Can seizures cause sudden death by ripping the walls of large blood vessels?

Occasionally a person wakes up from an epileptic seizure feeling chest pain, dizziness and other symptoms. The emergency room doctors caring for them run tests and much to their surprise find that the cause of their symptoms is a tear in a major thoracic artery such as the aorta . Some of these patients go into cardiac arrest and die shortly after. When asked about the seizure that started it all, these doctors typically say that it was a symptom of the arterial dissection.

After seeing such a patient in 2023 (who survived), I led a study of available published case reports about such patients which led us to publish a paper which argues that seizures at the onset of atraumatic arterial dissections are not symptoms but triggers for those dissections.

In the article we also propose the novel concept that sudden unexpected atraumatic acute arterial dissection-related death after seizure (SUADAS) is an independent cause of sudden death in epilepsy patients, which is distinct from sudden unexpected death in epilepsy (SUDEP).