Verbal autopsies and SUDEP.
There is a problem in defining the occurrence of sudden unexplained death in persons with epilepsy (SUDEP). The diagnosis of SUDEP in the United States is under-used as many do not use the term on the death certificate. SUDEP is found to be more prevalent worldwide than assumed. However, data for developing countries, which are even more limited than those for Europe and North America, and do not depend on the use of autopsies, indicate that SUDEP is an underreported cause of death in persons with epilepsy. To glean information about the circumstances of the "sudden death event" in epilepsy, the verbal autopsy may be used, that is, talking with family members and/or close friends of the patient who has died unexpectedly. In contrast to developing countries, where verbal autopsy may be the only means of establishing a possible or probable cause of death, the technique of verbal autopsy may have a different use in more affluent countries. It is a defined technique to help clarify questions not answered by the standard methods of coroner and postmortem reports and not available in medical records. The purpose of verbal autopsy can be multifaceted. When used in conjunction with postmortem autopsy data on persons who die from SUDEP, it can focus on retrospective data that provide additional help in identifying more accurately the cause of death and in conducting retrospective analysis of these postmortem examinations. The value of these cumulative data from all sources is that they provide information for future preventative policy. In circumstances where postmortem information is not or cannot be collected, verbal autopsies offer a method to find information regarding the cause of death, whether conducted in developing countries or in developed countries. In either case, the worldwide database on persons with epilepsy who die suddenly and unexpectedly will gain information that will help in determining the prevalence of SUDEP and contribute to the quest for identification of preventive interventions.
Center for Veterinary Medicine, US Food and Drug Administration, Rockville, MD 20855, USA. lathers@attglobal.net
Claire M
CM
Lathers
Paul L
PL
Schraeder
D001344:Autopsy; D002423:Cause of Death; D003645:Death, Sudden / Q000453:epidemiology / Q000209:etiology*; D004827:Epilepsy / Q000401:mortality*; D006801:Humans