Sudden Death in Epilepsy: A Study of Incidence in a Young Cohort with Epilepsy and Learning Difficulty

Abstract

Sudden death, often seizure related, may occur in patients with epilepsy. Population-based incidence is probably on the order of 1:1,000/year. The incidence is much higher in selected groups, however. We wished to establish the incidence of sudden unexpected death (SUD) in a young cohort with severe epilepsy and learning difficulties. The study cohort included 310 pupils with epilepsy enrolled at a special residential school between April 1970 and April 1993. The follow-up period totaling 4,135 person-years included a period of residence at the school as well as time after leaving. Age and sex standardized overall mortality ratio was 15.9 [95% confidence interval (CI) 10.6-23.0], with 20 of 28 deaths considered epilepsy related. An incidence of sudden death cases of 1:295/year was noted. All 14 sudden deaths occurred when the pupils were not under the close supervision of the school and most were unwitnessed, which has implications for prevention.

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

“…W większo-ści przypadków dochodzi do tego w nocy lub podczas snu, bez świadków zdarzenia [650]. Największym czynnikiem ryzyka SUDEP są częste drgawki, a zwłaszcza uogólnione drgawki toniczno-kloniczne [651][652][653][654][655][656][657][658][659][660].…”

Mortality and SUDEP in epilepsy patients treated with vagus nerve stimulation

“…20,23 In cohorts of epilepsy patients with learning difficulties, SMRs were between 5.0 and 15.9. 24,25 Ten of the 29 patients who died in our cohort had associated physical and/or mental handicap.…”

Sudden unexpected death in epilepsy: a silent killer

“…Most studies reported that only 10% of deaths were witnessed, usually in association with GTCS [13,14]. Another study on SUDEP among patients with learning disabilities found that all 14 deaths occurred while the patients were unsupervised and unobserved [20]. Some of the early studies on SUDEP reported that around 50% of patients were found dead in bed and the majority were in the prone position [21,22].…”