SUDDEN-DEATH IN EPILEPSY - A STUDY OF INCIDENCE IN A YOUNG COHORT WITH EPILEPSY AND LEARNING-DIFFICULTY

Sudden death, often seizure related, may occur in patients with epilep sy. Population-based incidence is probably on the order of 1:1,000/yea r. The incidence is much higher in selected groups, however. We wished to establish the incidence of sudden unexpected death (SUD) in a youn g cohort with severe epilepsy and learning difficulties. The study coh ort included 310 pupils with epilepsy enrolled at a special residentia l school between April 1970 and April 1993. The follow-up period total ing 4,135 person-years included a period of residence at the school as well as time after leaving. Age and sex standardized overall mortalit y 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 ca ses of 1:295/year was noted. All 14 sudden deaths occurred when the pu pils were not under the close supervision of the school and most were unwitnessed, which has implications for prevention.