title: Temporal trends in the mortality of people with epilepsy: a review.
abstract: OBJECTIVE
  It is now generally accepted that people with epilepsy are at increased risk of premature death compared with peers in the general population. It has, however, not been clearly established how this risk changes over time, nor whether mortality rates have been changing over time.
  
  
  METHODS
  We carried out a systematic review: (1) To determine the pattern of change of mortality risk relative to the general population in people with epilepsy in the course of their condition as measured by standardized mortality ratios (SMRs), by reviewing longitudinal prospective cohort studies. (2) To establish whether there have been any changes in reported mortality rates for epilepsy in general populations over time. This was complemented by comparison of SMRs in people with epilepsy in the same types of source populations (population-based, hospital-based, and institutional studies) in different time periods to ascertain any changes in reported mortality rates.
  
  
  RESULTS
  The SMR is highest in the initial years after diagnosis and subsequently decreases. There is a suggestion that there may be an increase after 10 years from diagnosis despite the fact that the majority of people in these cohorts are in long-term remission. There is no evidence that either the overall SMR or the mortality rate of people with epilepsy has changed significantly over time.
  
  
  CONCLUSIONS
  Further population and cohort studies are needed to confirm these findings.
authors.affiliation: Department of Clinical & Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, United Kingdom.
authors.forename: Aidan
authors.initials: A
authors.lastname: Neligan
authors.forename: Gail S
authors.initials: GS
authors.lastname: Bell
authors.forename: Simon D
authors.initials: SD
authors.lastname: Shorvon
authors.forename: Josemir W
authors.initials: JW
authors.lastname: Sander
mesh_terms: D000328:Adult; D002423:Cause of Death / Q000639:trends*; D002648:Child; D015331:Cohort Studies; D003431:Cross-Cultural Comparison; D004827:Epilepsy / Q000401:mortality*; D006801:Humans; D008137:Longitudinal Studies; D016017:Odds Ratio; D011446:Prospective Studies; D012016:Reference Values