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Investigative practice into sudden death in epilepsy: A global survey
Michael O Kinney1, Gavin McCluskey1, Daniel Friedman2
1Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, University College London Hospital, London, UK.
Acta Neurologica Scandinavica
|February 19, 2019
Summary
Sudden death in epilepsy investigation varies globally. Autopsy rates and clinician confidence are low, influenced by legal and cultural barriers, hindering accurate diagnosis and research.
Area of Science:
- Neurology
- Public Health
- Forensic Pathology
Background:
- Sudden death is a known complication of epilepsy.
- Understanding autopsy practices and diagnostic confidence is crucial for improving outcomes.
Purpose of the Study:
- To assess autopsy utilization for sudden death in epilepsy.
- To determine clinician confidence in diagnosing the cause of death.
- To identify factors influencing autopsy rates and diagnostic accuracy.
Main Methods:
- An online survey was distributed to International League Against Epilepsy (ILAE) chapter chairpersons.
- Perceptions on autopsy frequency, diagnostic confidence, and barriers were collected.
- Statistical analyses included chi-squared, Kruskal-Wallis, and Spearman rank tests.
Main Results:
- A 68% response rate was achieved from 77 chapter leaders.
- Legal, cultural, and family attitudes were major barriers to autopsy.
- Only 13% of clinicians expressed high confidence in cause of death accuracy.
- Higher autopsy rates correlated with greater diagnostic confidence.
Conclusions:
- Significant global disparities exist in investigating sudden death in epilepsy.
- Identified barriers necessitate a global public health strategy.
- Addressing these gaps can improve diagnosis and research for sudden death in epilepsy.
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