Review
Current concepts in medicine
Sudden unexpected death in
epilepsy
S D Lhatoo, Y Langan, J W A S Sander
Epilepsy Research
Group, University College London, Institute of Neurology, Queen Square,
London WC1N 3BG, UK
Accepted 7 June
1999
The majority of persons with epilepsy develop lasting remission
from seizures, although mortality is significantly greater than that of
the age-matched general population. Of the deaths that are thought to
be directly related to seizures, sudden unexpected death in epilepsy is
probably the commonest category; more so than status epilepticus or
seizure-related accidents. Annual incidence rates vary from 1 in 200 patients with chronic epilepsy to about 1 in 1000 in more
population-based studies. Young adults with severe, intractable
epilepsy appear to be the most frequently affected group and may have
even higher incidence rates. Other risk factors may also be important.
An area of great research interest, several pathogenetic mechanisms
have been postulated, centering mainly around cardiac rhythm and
central hypoventilation. Given the frequent devastation caused by
sudden unexpected death in epilepsy, the importance of seizure control
is emphasised.
Keywords: epilepsy; sudden death
© 1999 by The Fellowship of Postgraduate Medicine
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