title: A community study in Cornwall UK of sudden unexpected death in epilepsy (SUDEP) in a 9-year population sample.
abstract: OBJECTIVE
  Epilepsy-related death, particularly sudden unexpected death in epilepsy (SUDEP), is underestimated by healthcare professionals. One argument that physicians use to justify the failure to discuss SUDEP with patients and their families is that there is a lack of evidence for any protective interventions. However, there is growing evidence of potentially modifiable risk factors for SUDEP; although large-scale trials of interventions are still lacking. We determined the main risk factors associated with SUDEP in a comprehensive community sample of epilepsy deaths in Cornwall UK from 2004 to 2012.
  
  
  METHODS
  We systemically inspected 93 cases of all epilepsy and epilepsy associated deaths which occurred in Cornwall between 2004 and 2012 made available to us by the HM Cornwall coroner. These are the deaths where epilepsy was a primary or a secondary cause.
  
  
  RESULTS
  48 cases met the criteria for SUDEP and we elicited associated relevant risk factors. Many findings from our study are comparable to what has been reported previously. New points such as most of the population had increase in either or both seizure frequency/intensity within six months of death and majority did not have an epilepsy specialist review in the last one year to demise were noted.
  
  
  CONCLUSIONS
  This study is the first epidemiological study in England occurring in a whole population identifying systemically all deaths and the first large scale review in UK of SUDEP deaths since 2005. Being a community based study a key issue which was highlighted was that in the SUDEPs examined many might have been potentially preventable.
authors.affiliation: Cornwall Partnership NHS Foundation Trust, United Kingdom; Exeter Medical School, United Kingdom. Electronic address: rohit.shankar@cft.cornwall.nhs.uk.
authors.forename: Rohit
authors.initials: R
authors.lastname: Shankar
authors.affiliation: Cornwall Partnership NHS Foundation Trust, United Kingdom; MS Ramaiah Medical College and Hospitals, India.
authors.forename: Virupakshi
authors.initials: V
authors.lastname: Jalihal
authors.affiliation: UCL Institute of Neurology, United Kingdom.
authors.forename: Matthew
authors.initials: M
authors.lastname: Walker
authors.affiliation: Cornwall Partnership NHS Foundation Trust, United Kingdom; Exeter Medical School, United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Laugharne
authors.affiliation: RCHT, United Kingdom.
authors.forename: Brendan
authors.initials: B
authors.lastname: McLean
authors.affiliation: Coroner's Office, United Kingdom.
authors.forename: Emma
authors.initials: E
authors.lastname: Carlyon
authors.affiliation: SUDEP Action, United Kingdom.
authors.forename: Jane
authors.initials: J
authors.lastname: Hanna
authors.affiliation: SUDEP Action, United Kingdom.
authors.forename: Stephen
authors.initials: S
authors.lastname: Brown
authors.affiliation: Cornwall Partnership NHS Foundation Trust, United Kingdom.
authors.forename: Caryn
authors.initials: C
authors.lastname: Jory
authors.affiliation: Cornwall Partnership NHS Foundation Trust, United Kingdom.
authors.forename: Mike
authors.initials: M
authors.lastname: Tripp
authors.affiliation: RCHT, United Kingdom.
authors.forename: Adrian
authors.initials: A
authors.lastname: Pace
authors.affiliation: Cornwall Partnership NHS Foundation Trust, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Cox
authors.affiliation: RCHT, United Kingdom.
authors.forename: Scott
authors.initials: S
authors.lastname: Brown
mesh_terms: D000328:Adult; D002423:Cause of Death; D003645:Death, Sudden / Q000209:etiology* / Q000517:prevention & control; D004739:England; D004827:Epilepsy / Q000150:complications / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Epidemiology; Risk; SUDEP; Safety checklist; Sudden unexpected death in epilepsy