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

Authors

  • L. Nashef,

    Corresponding author
    1. Epilepsy Research Group, University Department of Clinical Neurology, Institute of Neurology, Queen Square, London and National Society for Epilepsy, Chalfont Centre, Chalfont St. Peter, Buckinghamshire
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  • D. R. Fish,

    1. Epilepsy Research Group, University Department of Clinical Neurology, Institute of Neurology, Queen Square, London and National Society for Epilepsy, Chalfont Centre, Chalfont St. Peter, Buckinghamshire
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  • S. Garner,

    1. Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, England
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  • J. W. A. S. Sander,

    1. Epilepsy Research Group, University Department of Clinical Neurology, Institute of Neurology, Queen Square, London and National Society for Epilepsy, Chalfont Centre, Chalfont St. Peter, Buckinghamshire
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  • S. D. Shorvon

    1. Epilepsy Research Group, University Department of Clinical Neurology, Institute of Neurology, Queen Square, London and National Society for Epilepsy, Chalfont Centre, Chalfont St. Peter, Buckinghamshire
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Address correspondence and reprint requests to Dr. L. Nashef at Epilepsy Research Group, Institute of Neurology, Queen Square, London WC1N 3BG, England.

Abstract

Summary: 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.

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