Mortality in epilepsy in the west of ireland: A 10-year review

Background. Sudden and unexpected death is not an uncommon event in otherwise healthy epileptics. Aims. To study the autopsied cases of sudden death in known epileptic patients in the West of Ireland. Methods. A retrospective study was carried out which involved the review of 3,103 autopsy reports over a 10-year period in Galway University Hospital. Results. Twenty-two cases were classified as sudden, unexpected death in epilepsy (SUDEP). Forty-five per cent had been found dead in bed. The mean age was 38 years and 68% were males. Of 16 cases with data about antiepileptic drug (AED) levels, 68% had absent or low levels at postmortem. Eighty-eight per cent of the cases had a past history of a generalised seizure. Pulmonary oedema was present in 86% of cases at postmortem. Conclusions. Compliance with treatment and frequent nightly observations to those at high risk of sudden death may help to minimise its incidence. The patients and their families should be aware of this potential outcome.