Causes of death in institutionalized epileptics

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Iivanainen M and Lehtinen J (1979) Causes of death in institutionalized epileptics. Epilepsia 20:5 485–91.

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Abstract: To assess the causes of death in institutionalized epileptics, the patient records, death certificates, and other data from the only hospital for epileptics in Finland (Vaajasalo Hospital) were reexamined. During the years 1900--1976, 179 inpatients in Vaajasalo Hospital died; this was 12% of all inpatients. The most common causes of death were as follows: pneumonia in 40 cases, seizures in 34 cases (single seizure in 18 and status epileptics in 16), drowning in 29 cases, stroke in 10 cases, and heart infarct in 9 cases. Chronic intoxication caused by phenytoin and/or phenobarbitol was a common supplementary factor leading to death in patients who died of pneumonia or seizures. Thirteen deaths were recorded as suicides or suspected suicides (11 by drowning and 2 by strangulation). The results reflect the severe epilepsy and the poor conditions of the patients, as well as the poor condition of the local facilities in the past. The information obtained should be useful in the effort to improve medical care for these patients.

Keywords: Epilepsy, Mortality, Cause of death, Drowning, Pneumonia


  • Examination of death records of Finnish hospital for epilepsy patients from 1900-1976. Of 179 deaths, seizures were the cause in 18 and status epilepticus in 16. ‘Chronic intoxication by phenytoin and/or phenobarbitol’ was considered to contribute to a number of these deaths. The authors also addressed time of day and time of year of death (), but did not separately consider deaths that might represent SUDEP according to time of day or year; the analysis is biased by the larger number of drownings in the summer, for example. A number of nighttime deaths were linked to asphyxia by signs on autopsy (), thus likely representing SUDEP as well.


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