Mortality in patients with refractory temporal lobe epilepsy at a tertiary center in Cuba

Abstract

Objectives: We aimed to investigate the prevalence and risk of mortality in patients with refractory temporal lobe epilepsy.

Methods: Eligible patients included all adults referred to the National Institute of Neurology (NIN) in Havana, Cuba. All patients were followed up for 9 years. All analyses were made with the data available at the last follow-up. The frequency of death related to refractory TLE was analyzed taking into account the total number of patients included in the study. We analyzed the causes of death for each case. Multivariate analysis was made to determine the specific variables related to the death. All values were statistically significant if p<0.05.

Results: Six out of 117 patients died during follow-up. Fifty percent of patients died because of suicide. Only the presence of aura, specifically experiential psychic auras, and prodromal depressive disorders were associated significantly with the deaths (p<0.05). Patients who died had a higher concern about their seizures than patients who were still alive at last follow-up (p<0.01); they also had a poor perception of the overall QOL (p<0.01); and they were more concerned about the possible medication side effects than patients who did not die (p<0.05). Logistic regression provided only one variable related to the deaths in our cohort in multivariate analysis: presence of prodromal depressive disorder.

Conclusion: The causes of death in patients with refractory temporal lobe epilepsy were similar to those documented in the general population of patients with epilepsy.

Keywords: Deaths on epilepsy; Mortality; Refractory temporal lobe epilepsy; SUDEP; Suicide.