A study
exploring the risks for premature death in the epilepsy community appeared in a
recent issue of Neurology.1 Five
hundred fifty-eight people with epilepsy were followed for 25 years. The
authors wished to identify predictors of longevity. They found that conditions
unrelated to epilepsy caused death in 59 percent (111/189) of the sample: most
commonly cancers not related to the nervous system followed by cardiovascular
diseases (heart attack, heart failure, etc.) and then cerebrovascular
conditions (stroke, etc.). Only 3 percent (6/189) died of their epilepsy, e.g.
SUDEP (sudden death in epilepsy), drowning or trauma.
The
death rate was found to be higher in the first two years after the initial
seizure, specifically associated with cancers. Pneumonia was the most common cause of death
occurring in 31.2 percent. Males and people who received early epilepsy-control
seemed protected against death. This gender difference was surprising since being
male is typically associated with having a shorter life-expectancy. More
studies need to explore this correlation. Conditions that strongly predicted mortality
included brain and non-brain cancers, dementia, Parkinson’s disease, stroke,
brain trauma and drug abuse.
Counseling
of the epilepsy population appears to be of primary importance. Physicians’
evaluations can detect malignancies and vascular disease followed by treatment.
Medical guidance can prevent many disease-related complications. These non-epilepsy
conditions must be addressed just as much as counseling individuals regarding
SUDEP (see Blog
#13 and Blog
#30) or status epilepticus (see Blog # 37).
11
Keezer
MR, Bell GS, Neligan A, et. al. Cause of Death and Predictors of Mortality in a Community-Based Cohort of People with Epilepsy. Neurology 2016; 86: 704-12.
Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. “DINGS” is his first novel. It is
a mother’s dramatic story that teaches epilepsy, now available in eBook,
audiobook and soft cover editions.
