Long-Term Mortality Risk of People with Epilepsy Who Underwent Seizure Monitoring

Shishir N Duble; V S Nandini; Ashalatha Radhakrishnan; Ramshekhar Menon; Ajith Cherian; P Sankara Sarma; Sanjeev V Thomas

doi:10.4103/aian.AIAN_134_18

Long-Term Mortality Risk of People with Epilepsy Who Underwent Seizure Monitoring

Ann Indian Acad Neurol. 2019 Oct-Dec;22(4):453-457. doi: 10.4103/aian.AIAN_134_18. Epub 2019 Oct 25.

Authors

Shishir N Duble¹, V S Nandini¹, Ashalatha Radhakrishnan¹, Ramshekhar Menon¹, Ajith Cherian¹, P Sankara Sarma², Sanjeev V Thomas¹

Affiliations

¹ Department of Neurology, R. Madhavan Nayar Centre for Comprehensive Epilepsy Care, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
² Department of Biostatistics, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.

Abstract

Aim: The aim is to study survival outcome and sudden unexpected death in epilepsy (SUDEP) of people with epilepsy who underwent epilepsy monitoring.

Subjects and methods: Between 2000 and 2004, 558 persons were admitted to the epilepsy monitoring unit of SCTIMST who fulfilled the selection criteria. Their survival status as on December 31, 2013, was ascertained by clinic attendance record and by mail or telephone contact.

Results: Five hundred and fifty-eight persons with epilepsy (males 319, 6408 person-years) were included in this study. There had been 20 deaths till December 31, 2013, and 5 additional deaths were reported when followed up till May 2016. The standardized mortality ratio was 5.35 and higher for males (6.25) than for females (3.52). Those with generalized seizures (tonic and myoclonic seizures), electroencephalography (EEG) showing multifocal and generalized interictal discharges, and polypharmacy had a higher risk of mortality. SUDEP accounted for 5 deaths.

Conclusion: People with refractory epilepsy who had undergone presurgical video EEG monitoring had higher mortality risk. Generalized or myoclonic seizures, multifocal or generalized interictal discharges, and polypharmacy independently increased their risk of mortality. SUDEP is an important cause of death.

Keywords: Standardized mortality ratio; Survival outcome; sudden unexpected death.