Epilepsy is a chronic neurological disorder, hallmark of which is unpre-dictable seizures. The leading cause of death in people with uncontrolled sei-zures is the sudden unexpected death for epilepsy (SUDEP), which is believed to share genes with sudden cardiac death (SCD). T-wave alternans (TWA), consisting in an abnormal alternation of the electrocardiographic (ECG) T-wave amplitude and/or morphology, is an index of SCD. Still, very few studies have investigated the occurrence of TWA in epileptic patients. Aim of the present work was to evaluate TWA occurrence in proximity of epileptic seizures. To this aim, seven 1-to-4 hour ECG recordings from five partial epileptic patients constituting the “Post-Ictal Heart Rate Oscillations in Partial Epilepsy Database” by Physionet were analyzed for automatic TWA identification by the heart-rate adaptive match filter (HRAMF). Onsets and offsets of epileptic seizures occurring during ECG recordings were annotated. ECG windows starting 10 min before seizures and ending 10 min after sei-zures were extracted and further processed to characterize trends of heart rate (HR), mean TWA (meanTWA) and maximum TWA (maxTWA) in seizure proximity. Specifically, HR, meanTWA and maxTWA occurring 10-to-9 min before seizure onsets, during seizures, and 9-to-10 min after seizure offset, were quantified and compared. Overall, TWA was analyzed in proximity of 9 epileptic seizures (seizure duration:1.3±0.5 min). HR and TWA measures were higher during seizures (HR:96 bpm, P<0.05; meanTWA:46 µV; maxTWA:105 µV) than before (HR:70 bpm; meanTWA:31 µV; maxTWA:54 µV) or after (HR:70 bpm; meanTWA:30 µV; maxTWA:66 µV). In all cases, TWA levels remained significantly (P<0.05) higher than what previously observed in healthy subjects, in both seizure and non-seizure conditions. In conclusion, in proximity of epileptic seizures, our partial epileptic patients show increased levels of TWA and thus are at increased risk of SCD, possibly associated with SUDEP.