title: Sudden unexpected death in epilepsy: assessing the public health burden.
abstract: OBJECTIVE
  There is not yet a clear consensus on the incidence of sudden unexpected death in epilepsy (SUDEP) or the extent of its burden on public health. In this systematic review, we seek to summarize the incidence of SUDEP and its age distribution, as well as the years of potential life lost and cumulative risks of SUDEP for persons with epilepsy.
  
  
  METHODS
  We conducted a systematic search for epidemiologic studies of sudden death in epilepsy and rated their quality of evidence. We pooled data from comparable higher quality population-based studies of SUDEP incidence across all age groups, calculating the overall incidence of SUDEP per 100,000 population, and per 1,000 people with epilepsy. Using standard formulas, we also calculated the years of potential life lost and cumulative risks associated with SUDEP.
  
  
  RESULTS
  SUDEP has an estimated overall crude annual incidence rate of 0.81 cases per 100,000 population, or 1.16 cases per 1,000 patients with epilepsy. Comparing years of potential life lost from SUDEP with selected other neurologic diseases, SUDEP ranks second only to stroke.
  
  
  CONCLUSIONS
  Despite limitations to the data on which our analysis is based, we conclude that the public health burden of SUDEP, which has previously been underappreciated, is substantial and deserves much more attention from clinicians, researchers, and the public health community.
authors.affiliation: Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, U.S.A.
authors.forename: David J
authors.initials: DJ
authors.lastname: Thurman
authors.forename: Dale C
authors.initials: DC
authors.lastname: Hesdorffer
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: French
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003645:Death, Sudden / Q000453:epidemiology / Q000209:etiology*; D004827:Epilepsy / Q000401:mortality*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008017:Life Expectancy; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult
keywords: Epilepsy; Incidence; Sudden death; Systematic review