Irish Journal of Medical Science

, Volume 171, Issue 4, pp 199–201 | Cite as

Mortality in epilepsy in the West of Ireland: a 10-year review

Original Paper



Sudden and unexpected death is not an uncommon event in otherwise healthy epileptics.


To study the autopsied cases of sudden death in known epileptic patients in the West of Ireland.


A retrospective study was carried out which involved the review of 3,103 autopsy reports over a 10-year period in Galway University Hospital.


Twenty-two cases were classified as sudden, unexpected death in epilepsy (SUDEP). Forty-five per cent had been found dead in bed. The mean age was 38 years and 68% were males. Of 16 cases with data about antiepileptic drug (AED) levels, 68% had absent or low levels at postmortem. Eighty-eight per cent of the cases had a past history of a generalised seizure. Pulmonary oedema was present in 86% of cases at postmortem.


Compliance with treatment and frequent nightly observations to those at high risk of sudden death may help to minimise its incidence. The patients and their families should be aware of this potential outcome.


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  1. 1.
    Zielinsk JJ. Epilepsy and mortality rate and cause of death.Epilepsia 1974; 15: 191–201.CrossRefGoogle Scholar
  2. 2.
    Nashef L, Brown S. Epilepsy and sudden death.Lancet 1996; 348: 1324–5.CrossRefPubMedGoogle Scholar
  3. 3.
    Timmings PL. Sudden unexpected death in epilepsy: a local audit.Seizure 1993; 2: 287–90.CrossRefPubMedGoogle Scholar
  4. 4.
    Leestma JE, Walczak T, Hughes JR, Kalelkar MB, Teas SS. A prospective study on sudden unexpected death in epilepsy.Ann Neurol 1989; 26: 195–203.CrossRefPubMedGoogle Scholar
  5. 5.
    Langan Y, Nolan N, Hutchinson M. The incidence of sudden unexpected death in epilepsy in South Dublin and Wicklow.Seizure 1998; 7: 355–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Nashef L, Garner S, Sander JW, Fish DR, Shorvon SD. Circumstances of death in sudden death in epilepsy: interviews of bereaved relatives.J Neuro Neurosurg Psychiatry 1998; 64: 349–52.CrossRefGoogle Scholar
  7. 7.
    Langan Y, Nashef L, Sander JW. Sudden unexpected death in epilepsy: a series of witnessed deaths.J Neurol Neurosurg Psychiatry 2000; 68: 211–3.CrossRefPubMedGoogle Scholar
  8. 8.
    Timmings PL. Sudden unexpected death in epilepsy: Is carbamazepine implicated?Seizure 1998; 7: 289–91.CrossRefPubMedGoogle Scholar
  9. 9.
    Tennis P, Cole TB, Annegers JF, Leestma JE, McNutt M, Rajput A. A cohort study of incidence of sudden unexplained death in persons with seizure disorder treated with antiepileptic drugs in Saskatchewan, Canada.Epilepsia 1995; 36: 29–36.CrossRefPubMedGoogle Scholar
  10. 10.
    Leestma JE, Kalelkar MB, Teas SS, Jay GW, Hughes JR. Sudden unexpected death associated with seizure: Analysis of 66 cases.Epilepsia 1984; 25: 84–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Lund A, Gormsen H. The role of antiepileptics in sudden death in epilepsy.Acta Neurol Scand 1985; 72: 444–6.PubMedCrossRefGoogle Scholar
  12. 12.
    Brown SW, Mawer GE, Lawler W et al. Sudden death and epilepsy.Lancet 1990; 335: 606–7.CrossRefPubMedGoogle Scholar
  13. 13.
    Tomson T, Skold A, Holmgen P, Nilsson L, Danielson B. Post mortem changes in blood concentrations of phenytoin and carbamazepine: An experimental study.Therapeutic Drug Monitoring 1998; 20: 309–12.CrossRefPubMedGoogle Scholar
  14. 14.
    Terrence CF, Rao GR, Perper JA. Neurogenic pulmonary oedema in unexpected, unexplained death of epileptic patients.Ann Neurol 1981; 9: 458–64.CrossRefPubMedGoogle Scholar
  15. 15.
    Bennani F, Connolly CE. Sudden Unexpected Death in Young Adults including Four Cases of SADS: a 10 year review from the west of Ireland.Med Sci Law 1997; 37: 242–7.PubMedGoogle Scholar
  16. 16.
    Dasheiff RM, Dickinson LJ. Sudden unexpected death of epileptic patient due to cardiac arrhythmia after seizure.Arch Neurol 1986; 43: 194–6.PubMedGoogle Scholar
  17. 17.
    Nashef L, Walker F, Allen P, Sander JW, Shorvon SD, Fish DR. Apnoea and bradycardia during epileptic seizures: relation to sudden death in epilepsy.J Neurol Neurosurg Psychiatry 1996; 60: 297–300.CrossRefPubMedGoogle Scholar
  18. 18.
    Nilsson L, Farahmand BY, Persson PG, Thiblin I, Thomson T. Risk factors for sudden unexpected death in epilepsy: a case-control study.Lancet 1999; 353: 888–93.CrossRefPubMedGoogle Scholar
  19. 19.
    Nilsson L, Bergman U, Diwan V, Farahmand BY, Persson PG, Thomson T. Antiepileptic drug therapy and its management in sudden unexpected death in epilepsy: a case control study.Epilepsia 2001; 42 (5): 667–73.CrossRefPubMedGoogle Scholar
  20. 20.
    Ficker DM. Sudden unexpected death and injury in epilepsy.Epilepsia 2000; 41 (Suppl 2): S7-S12.CrossRefPubMedGoogle Scholar

Copyright information

© Springer 2002

Authors and Affiliations

  1. 1.Department of HistopathologyUniversity College HospitalGalwayIreland
  2. 2.Department of Histopathology, Duncan Bld.Royal Liverpool HospitalUK

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