Sudden death in epilepsy: A study of incidence in a young cohort with epilepsy and learning difficulty

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Nashef L, Fish DR, Garner S, Sander JW, and Shorvon SD (1995) Sudden death in epilepsy: A study of incidence in a young cohort with epilepsy and learning difficulty. Epilepsia 36:12 1187–94.

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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.

Keywords: Sudden death, Epilepsy, Mortality, Learning difficulty

Context

  • Among 310 children in the cohort studied over 24 years, 20 of 28 deaths were assessed as epilepsy related. Sudden death incidence was 1 in 295 person-years. All 14 sudden deaths occurred when students were not at school, suggesting that close monitoring may prevent SUDEP, and also having implications for pathogenesis.

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