Sudden unexpected death in epilepsy. A nationwide population-based study.

Area of Science:

• Neurology
• Epidemiology
• Public Health

Background:

• Sudden unexpected death in epilepsy (SUDEP) is a significant concern, yet its incidence varies across studies.
• Understanding SUDEP's population-based incidence is crucial for public health initiatives and patient safety.

Purpose of the Study:

• To determine the incidence of SUDEP in the entire Icelandic population over a 20-year period.
• To provide accurate SUDEP incidence data for both the general and epilepsy populations.

Main Methods:

• A nationwide study in Iceland from January 1, 1991, to December 31, 2010.
• Inclusion of all unexpected epilepsy-related deaths, with case ascertainment through autopsies, drug reimbursements, death certificates, and medical records.
• Calculation of SUDEP incidence based on the total Icelandic population and an estimated epilepsy cohort.

Main Results:

• Identified 37 SUDEP cases (29 definite, 4 definite plus, 4 probable).
• SUDEP incidence was 0.6 per 100,000 person-years in the general population, higher in men.
• Estimated SUDEP incidence in the epilepsy population was 1.3 per 1000 person-years; SUDEP comprised 0.1% of all deaths.

Conclusions:

• SUDEP is a notable cause of mortality, particularly in working-age individuals.
• This study offers reliable SUDEP incidence data from an unselected national population.
• The SUDEP incidence in the epilepsy population aligns with findings from previous international studies.