Causes of death in institutionalized epileptics

To assess the causes of death in institutionalized epileptics, the patient records, death certificates, and other data from the only hospital for epileptics in Finland (Vaajasalo Hospital) were reexamined. During the years 1900--1976, 179 inpatients in Vaajasalo Hospital died; this was 12% of all inpatients. The most common causes of death were as follows: pneumonia in 40 cases, seizures in 34 cases (single seizure in 18 and status epileptics in 16), drowning in 29 cases, stroke in 10 cases, and heart infarct in 9 cases. Chronic intoxication caused by phenytoin and/or phenobarbitol was a common supplementary factor leading to death in patients who died of pneumonia or seizures. Thirteen deaths were recorded as suicides or suspected suicides (11 by drowning and 2 by strangulation). The results reflect the severe epilepsy and the poor conditions of the patients, as well as the poor condition of the local facilities in the past. The information obtained should be useful in the effort to improve medical care for these patients.