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Excess mortality in remote symptomatic epilepsy.

Steven Day1, David Strauss, Robert Shavelle

  • 1University of California Life Expectancy Project, Department of Pediatrics and Neurology, University of California at San Francisco, USA. Day@LifeExpectancy.com

Journal of Insurance Medicine (New York, N.Y.)
|February 20, 2004
PubMed
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Epilepsy itself, not just underlying conditions, increases mortality risk. The risk varies with seizure type and frequency, with status epilepticus posing the highest risk.

Area of Science:

  • Neurology
  • Public Health
  • Epidemiology

Background:

  • Estimates of excess mortality in epilepsy patients vary widely.
  • The contribution of seizures versus underlying conditions to epilepsy mortality is unclear.
  • This study provides evidence that epilepsy itself is linked to increased mortality.

Purpose of the Study:

  • To investigate the association between epilepsy and excess mortality.
  • To determine if epilepsy per se, independent of underlying conditions, increases mortality risk.
  • To analyze how seizure severity and frequency influence mortality rates.

Main Methods:

  • A cohort study of 80,682 individuals aged 5-65 in California from 1988-1999.
  • Included individuals with good motor function and moderate intellectual disability to isolate epilepsy's effect.

Related Experiment Videos

  • Compared mortality rates between individuals with and without epilepsy using 506,204 person-years of data.

    • Main Results:

    • Individuals with epilepsy exhibited higher mortality rates than those without.
    • Excess death rates (EDRs) correlated with seizure type and recency.
    • EDRs per 1000 person-years: 6 for status epilepticus, 5 for generalized tonic-clonic seizures, 3 for other recent seizures, <1 for remote seizures.

    Conclusions:

    • Epilepsy is independently associated with increased mortality.
    • The study's EDRs offer a more precise measure of epilepsy-related excess mortality.
    • Seizure characteristics significantly impact the excess mortality associated with epilepsy.