Abstracts

Rationale: Sudden unexpected death in epilepsy (SUDEP) is well recognized and widely reported but remains poorly understood. Sudden death in young adults is 27 times more common in epilepsy patients than in control populations. The incidence of SUDEP in New Zealand is estimated to be about 40 cases every year. Methods: Coroner’s reports of all possible cases of SUDEP in New Zealand from 2007-2016 (n=190) were obtained and post-mortem and toxicology results were reveiwed. Cases were categorised following published criteria. Results: Age range was 1.5 - 67 years (mean 37 years), 61% were male and 87% of the deaths occurred at home, with 74% found dead in their bed or bedroom. Toxicology detected a single AED in 68 (41%) people, 2 AEDs in 32 (19%) people and 3 AEDs in 4 people (2%). For 62 people (37%) AED use was not detected or not stated. Approximately half who took an AED were taking either Sodium Valproate or Carbamazepine. The majority did not work with only 30% working or retired at the time of death; 15% were children or students, and information regarding work status was not available for 11%. Conclusions: This study suggests that people with epilepsy who die from SUDEP in New Zealand are young and were often taking AEDs when they died. SUDEP cases are likely to be under-reported particularly in older population. Standardization of post-mortem documentation would increase the yield of this type of review and may eventually lead to interventions that reduce premature deaths in epilepsy populations. Funding: No funding