The Causes of Death in Epilepsy: A Systematic Review

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Ostler A, Cousins S, Ridsdale L. (2015) The Causes of Death in Epilepsy: A Systematic Review. SUDEP Action 2015.

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Abstract: BACKGROUND: Population-based studies have consistently found a two to three fold increase in mortality rates in patients with epilepsy (PWE) compared with the general population. The cause of this increase remains uncertain but several risk factors have been identified including non-adherence to medication, treatment for depression and alcohol abuse. AIM: To describe mortality rates in individuals with epilepsy and examine amenable causes of death. METHOD: A search of MEDLINE and PsycINFO lead to 14 papers being reviewed. The inclusion criteria stated that papers had to examine mortality rates in PWE and had to look at the role of psychological variables in the cause of death. RESULTS: Mortality and suicide rates were increased in PWE. PWE were at higher risk of being diagnosed with a psychiatric disorder than the general population. Being diagnosed with a comorbid psychiatric disorder was significantly associated with external cause of death (suicide and accidents) in PWE. Non-adherence to medication increased mortality rates by 50%. CONCLUSION: Psychiatric disorders and drug and alcohol abuse disorders are treatable and non-adherence with medication can be reduced through improving patient education. This may reduce some causes of death in epilepsy.

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