Neurology| September 01 2002 Risk and Cause of Death in Children with Epilepsy AAP Grand Rounds (2002) 8 (3): 26–27. https://doi.org/10.1542/gr.8-3-26 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Risk and Cause of Death in Children with Epilepsy. AAP Grand Rounds September 2002; 8 (3): 26–27. https://doi.org/10.1542/gr.8-3-26 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: epilepsy, cause of death Source: Camfield CS, Camfield PR, Veugelers PJ. Death in children with epilepsy: a population-based study. Lancet. 2002;359:1891–1895. The risk factors and frequency of death in childhood epilepsy were assessed in a population-based cohort study at Dalhousie University, Halifax, Nova Scotia, Canada. Of 692 children who developed epilepsy during 1977–85, 26 (3.8%) had died by 1999. Frequency of death was 5.3 times higher than in the reference population of Nova Scotia children and young people in the 1980s and 8.8 times higher than in the 1990s. The mortality at 20 years after onset was 6.1% compared to .88% in the reference population, matched for age and gender. Onset of seizures in the first year carried a significantly increased risk of mortality compared to later onset epilepsy. Of 85 children with secondary generalized epilepsy, 15% died, compared to 2% of 510 with partial and primary generalized epilepsy and 1% of 97 with absence epilepsy. Severe disorders associated with functional neurological deficit were associated with 22 times greater risk of death and were the cause of death in 22 children at a mean age of 10 years (range 1–29), independent of gender, age, and epilepsy type. Aspiration pneumonia was the cause of death in 14, infection in 3, shunt malfunction 1, pulmonary embolism 1, congestive heart failure 1, gastroesophageal reflux 1, and status epilepticus in 1. The rate of death in patients without severe neurological deficit was .8% (of 591), similar to that in the reference population. Four deaths were unexpected, all in young adults, aged 18–30 years, without severe neurological deficits. Suicide was the cause in 2, homicide in 1, and there was 1 sudden unexpected death, which was unexplained at autopsy in a 21-year-old woman with tuberous sclerosis who had several seizures during sleep. Functional neurological deficit was the only independent determinant of mortality. Children with epilepsy have more than 5 times the risk of dying in the first 20 years after onset of seizures. Most deaths are related to comorbid, severe neurological disorders associated with functional neurological deficit and not to the epilepsy per se. Cerebral palsy is an example of a severe neurological disorder that predisposes to death in epilepsy.l The authors have demonstrated that death from seizures themselves is uncommon, a finding that should help to allay the fear often expressed by parents of a child with epilepsy. These findings are similar to those of a Netherlands study2 of a cohort of 472 children, which showed a mortality rate of 3.8/1,000 person-years, 7 times higher than expected. None of 328 children with nonsymptomatic (idiopathic) epilepsy died. In those with symptomatic epilepsy, the mortality risk was 22.9 versus .39 expected in a control population. Among the 9 deaths in this prospective study, none were sudden unexpected and unexplained (SUDEP). SUDEP risk factors are usually multiple and include early-onset epilepsy, poor seizure control, polytherapy with antiepileptic drugs (AED), and frequent dose adjustments or abrupt AED withdrawal.3 An accurate initial diagnosis is important... You do not currently have access to this content.