Long-term mortality in childhood-onset epilepsy

Area of Science:

• Neurology
• Pediatrics
• Epidemiology

Background:

• Limited data exists on long-term mortality in well-characterized pediatric epilepsy cohorts.
• This study investigates long-term mortality in a Finnish cohort diagnosed with epilepsy in childhood.

Purpose of the Study:

• To assess long-term mortality in a population-based cohort of children with epilepsy.
• To identify risk factors associated with increased mortality, including epilepsy-related deaths and sudden unexplained death.

Main Methods:

• A population-based cohort of 245 children diagnosed with epilepsy in 1964 was prospectively followed for 40 years.
• Seizure outcomes and mortality rates were assessed, with a high autopsy rate facilitating specific diagnoses.
• Rates of sudden, unexplained death were specifically estimated.

Main Results:

• Overall mortality was 24% (60 deaths), three times higher than the general population.
• Mortality was significantly higher in subjects not in 5-year terminal remission (48%) and those with remote symptomatic epilepsy (37%).
• Epilepsy-related deaths accounted for 55% of all deaths, including sudden unexplained death in 18 subjects (30%).

Conclusions:

• Childhood-onset epilepsy is associated with a substantial risk of epilepsy-related mortality, including sudden unexplained death.
• The risk of death is particularly elevated in children with epilepsy who are not in remission.
• These findings highlight the critical need for vigilant monitoring and management of childhood epilepsy to mitigate mortality risks.