title: Mortality in Dravet syndrome: A review.
abstract: Premature mortality is a major issue in Dravet syndrome (DS). To improve understanding of DS premature mortality, we conducted a comprehensive literature search with a particular emphasis on SUDEP.
  
  
  
  We searched PubMed, Embase, Web of Science, Cochrane, CENTRAL, CINAHL, PsycINFO, Academic Search Premier, and ScienceDirect on the following terms: "Dravet syndrome", "severe myoclonic epilepsy", "SMEI", "mortality", "survivors", "prognosis", and "death". DS cases or cohorts studies reporting mortality were included.
  
  
  
  The search yielded 676 articles and 86 meeting abstracts. After removing duplicates and screening titles and abstracts, full text of 73 articles was reviewed. Only 28 articles and six meeting abstracts met inclusion criteria. Five articles and four meeting abstracts were excluded, as the case(s) were also described elsewhere. After checking the references, five additional studies were included. The 30 items reported 177 unique cases. Sudden unexpected death in epilepsy was the likely cause in nearly half of the cases (n=87, 49%), followed by status epilepticus (n=56, 32%). Drowning or accidental death was reported in 14 cases (8%), infections in 9 (5%), other causes in six (3%), and unknown in five (3%). Age at death was reported for 142 of the 177 cases (80%), with a mean age of 8.7±9.8years (SD); 73% died before the age of 10years.
  
  
  
  Dravet syndrome is characterized by high epilepsy-related premature mortality and a marked young age at death. Sudden unexpected death in epilepsy is the leading reported cause of death in DS, accounting for nearly half of all deaths. The cause of this excess mortality remains elusive but may be explained by epilepsy severity, as well as genetic susceptibility to SUDEP.
authors.affiliation: Stichting Epilepsie Instellingen Nederland - SEIN, Heemstede & Zwolle, The Netherlands; NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Epilepsy Society, Bucks SL9 0RJ, UK.
authors.forename: Sharon
authors.initials: S
authors.lastname: Shmuely
authors.affiliation: NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Epilepsy Society, Bucks SL9 0RJ, UK.
authors.forename: Sanjay M
authors.initials: SM
authors.lastname: Sisodiya
authors.affiliation: Stichting Epilepsie Instellingen Nederland - SEIN, Heemstede & Zwolle, The Netherlands; Department of Genetics, Centre for Molecular Medicine, University Medical Centre Utrecht, The Netherlands.
authors.forename: W Boudewijn
authors.initials: WB
authors.lastname: Gunning
authors.affiliation: Stichting Epilepsie Instellingen Nederland - SEIN, Heemstede & Zwolle, The Netherlands; NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Epilepsy Society, Bucks SL9 0RJ, UK.
authors.forename: Josemir W
authors.initials: JW
authors.lastname: Sander
authors.affiliation: Stichting Epilepsie Instellingen Nederland - SEIN, Heemstede & Zwolle, The Netherlands; NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Epilepsy Society, Bucks SL9 0RJ, UK; Department of Neurology, LUMC Leiden University Medical Centre, Leiden, The Netherlands. Electronic address: rthijs@sein.nl.
authors.forename: Roland D
authors.initials: RD
authors.lastname: Thijs
mesh_terms: D002648:Child; D003645:Death, Sudden; D004831:Epilepsies, Myoclonic / Q000401:mortality*; D006801:Humans
keywords: Dravet; SCN1A; Status epilepticus; Sudden unexpected death in epilepsy