A population-based post mortem study of sudden unexpected death in epilepsy

Clark, Damian and Riney, Kate (2015) A population-based post mortem study of sudden unexpected death in epilepsy. Journal of Clinical Neuroscience, 23 58-62. doi:10.1016/j.jocn.2015.04.027

Author Clark, Damian
Riney, Kate
Title A population-based post mortem study of sudden unexpected death in epilepsy
Journal name Journal of Clinical Neuroscience   Check publisher's open access policy
ISSN 1532-2653
Publication date 2015-09-19
Year available 2015
Sub-type Article (original research)
DOI 10.1016/j.jocn.2015.04.027
Open Access Status Not Open Access
Volume 23
Start page 58
End page 62
Total pages 5
Place of publication London, United Kingdom
Publisher Churchill Livingstone
Language eng
Subject 2728 Clinical Neurology
2808 Neurology
2737 Physiology (medical)
2700 Medicine
Abstract The aim of this study was to review population autopsy data on epilepsy-related deaths (ERD) in Queensland, Australia, to establish the incidence of autopsy-confirmed sudden unexpected death in epilepsy (SUDEP), explore factors associated with SUDEP, and determine if complete autopsy examinations of SUDEP were performed. All autopsy reports for a 5 year period in Queensland were electronically searched for the terms ‘epilepsy’ or ‘seizure’. The identified reports were reviewed, and data were extracted for all ERD. In the study period, 175 ERD were identified from autopsy records (123 SUDEP, 34 accident-related, 3 due to status epilepticus). From data available on the prevalence of epilepsy in Queensland (National Health Survey), the incidence of autopsy-confirmed SUDEP was 0.7 per 1000 person years (95% confidence interval 0.5–1.2 per 1000 person years). The factors associated with SUDEP were male sex (for those >18 years) and subtherapeutic anticonvulsant medication levels (found in 55%). Where recorded, the majority of deaths happened in the person’s usual residence (90%), were overnight (70%) and unwitnessed (87%), with the person found prone (74%), in or adjacent to their bed (49%) and with signs of proximate seizure (60%). A complete autopsy was undertaken for only 59% of cases, the majority in urban locations. This study provides support for an unwitnessed overnight seizure being a key factor in autopsy-confirmed SUDEP in Queensland.
Keyword Autopsy
Post mortem
Sudden unexpected death
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
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