Population-based study of the incidence of sudden unexplained death in epilepsy.
OBJECTIVE
To determine the population-based incidence of sudden unexplained death in epilepsy (SUDEP) and to determine the risk of SUDEP compared with the general population.


BACKGROUND
Prior studies of SUDEP have described a wide range of incidence and have suffered from selection bias and other methodologic limitations. A population-based study of the incidence of SUDEP has never been performed. Furthermore, the risk of sudden death in the epilepsy population has not been compared with that of the general population.


METHODS
All deaths in persons whose epilepsy was diagnosed between 1935 and 1994 in Rochester, MN, were reviewed. The rate of SUDEP was compared with the expected rate of sudden death in the general population for patients age 20 to 40 years to determine the standardized mortality ratio (SMR).


RESULTS
We identified nine cases of SUDEP. SUDEP accounted for 8.6% (7 of 81) of the deaths in persons 15 to 44 years of age. The incidence of SUDEP was 0.35 per 1,000 person-years. SMR for SUDEP was 23.7 (95% confidence interval, 7.7 to 55.0) compared with the general population.


CONCLUSIONS
The incidence of SUDEP in our study was 0.35 per 1,000 person-years. SUDEP was responsible for 1.7% of deaths in our cohort. SUDEP is a rare cause of death in the epilepsy population but exceeds the expected rate of sudden death in the general population by nearly 24 times.
Ficker
D M
DM
Department of Neurology, Mayo Clinic, Rochester, MN, USA.
So
E L
EL
Shen
W K
WK
Annegers
J F
JF
O'Brien
P C
PC
Cascino
G D
GD
Belau
P G
PG
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001344:Autopsy; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003645:Death, Sudden / Q000453:epidemiology*; D004827:Epilepsy / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology