A review of research on epilepsy deaths is published on this site following presentation as a poster at the RCGP national conference this autumn. The review focuses on behavioural and psychosocial risks and highlights the importance of interventions that could help reduce deaths that might be amenable to better medical care, such as accidents and suicide. The review was written by a third year clinical medical student, supervised by Professor Ridsdale, Chair of Neurology & Psychiatry Teaching and Dr Cousins at King’s College London.
Professor Ridsdale has previously led work on epilepsy mortality trends and risk using a very large general practice population. This pilot study was commissioned by SUDEP Action in 2011 and identified risks that could be flagged up in general practice and potential for intervention (Ridsdale et al. Epilepsy mortality and risk factors for death in epilepsy: a population-based study. British Journal of General Practice 2011;61(586):e271-e8)
The review paper published today examines mortality, suicide and accident rates together with risk factors for mortality including; substance-related disorders, psychiatric disorders, accidents and non-adherence to anti- epileptic drugs (AED).
The review found:
- Being seizure free (no seizures within the previous 12 months) was associated with a lower mortality rate.
- Not taking epilepsy medications increased risk by 50%.
- People with a psychiatric disorder and people misusing alcohol were high risk groups.
- The incidences of depressive symptoms are significantly higher in people with epilepsy compared with the general population and patients with other long-term conditions
Jane Hanna from SUDEP Action said:
“It is hoped that this review will stimulate GP research which may address risks for death in epilepsy in primary care. Proven interventions are still lacking but psychiatric disorders and substance abuse are treatable. Seizures are treatable, and non-collection of prescriptions is detectable and potentially worth addressing in primary care. We were pleased to sponsor a student at King’s this year as part of our ongoing collaboration with King’s College, London.”
Professor Ridsdale from King’s College, London said: “Community interventions including patient education and support addressing socio-economic and educational disadvantage, inequality of access to secondary care through lack of agreed pathways, depression, stigma and the reasons why patients are not taking medications need to be developed and supported”.
Summary of other findings
- People with epilepsy were over three times more likely to commit suicide.
- Being diagnosed with a psychiatric disorder was a strong risk factor.
- The risk of suicide was increased for patients who were not seizure free.
Findings on Accidents
- Accidents were the third cause of greatest excess mortality in people with chronic epilepsy.
- Not taking anti-epileptic medication increased the risk of accidents by 50%.
- People with a psychiatric disorder or misusing alcohol were at increased risk of death from injury.
The full report is available here:
The Causes of Death in Epilepsy