Mortality risk in children with epilepsy: The Dutch Study of Epilepsy in Childhood

Objective. Long-term follow-up studies of patients with epilepsy have revea led an increased mortality risk compared with the general population. Morta lity of children who have epilepsy in modern times is as yet unknown. There fore, the objective of this study was to determine mortality of children wh o have epilepsy in comparison with the general population. Methods. Between August 1988 and August 1992, 472 children, aged 1 month to 16 years, who presented in 1 of the participating hospitals with 2 or more newly diagnosed unprovoked seizures or at least 1 status epilepticus were enrolled in the study. All children were followed for 5 years or until deat h. The number of deaths observed during follow-up was compared with the exp ected number of deaths in the same age group in the general population in t he Netherlands. Results. Nine children died during follow-up, amounting to a mortality rate of 3.8/1000 person-years, which is sevenfold higher than expected (95% con fidence interval = 2.4-11.5). No deaths were observed among the 328 childre n who had epilepsy of nonsymptomatic cause. All deceased children had epile psy that was caused by a static or progressive neurologic disorder (mortali ty risk = 22.9; 95% confidence interval = 7.9-37.9). None of them died from sudden unexpected and unexplained death of epilepsy. Conclusions. In our cohort, we found no indication that children who have n onsymptomatic epilepsy have an increased mortality risk compared with the g eneral population, whereas children who have symptomatic epilepsy have a 20 -fold increased mortality risk. These data provide guidance for counseling parents of children who have epilepsy.