Abstracts

RATIONALE: The aim of this work was to examine the influence of various parameters on the risk, for an individual with epilepsy, of sudden death. METHODS: Cases were notified by coroners, neurologists via the British Neurological Surveillance Unit and the charity 'Epilepsy Bereaved?' with whose assistance bereaved families were interviewed. All cases underwent post mortem examination and background information was obtained. Each case had four controls with epilepsy, matched for age and geographical loation, selected at random using the Medical Research Council(MRC) general practice research framework. Logistic regression analysis was performed and Odds ratios determined. RESULTS: 154 SUDEP cases have been identified, 97 men and 57 women wiuth as mean age of 32 years. The majority of individuals were found dead in bed and there was evidence to support a recent seizure in many. A recent convulsive seizure increased the risk of SUDEP (OR 850) as did polytherapy(OR 96) and increasing duration of epilepsy(OR 1.1)We found that sleeping with another individual in the same room at night reduced the risk of SUDEP(OR 0.07)as did the use of special precautions (OR 0.02). Special precautions is defined as regular checks throughout the night or the use of a listening device. CONCLUSIONS: SUDEP is a seizure related phenomenon and optimisation of seizure control is important in its prevention. We have found that sleeping alone at night increases the risk of SUDEP and it may be that attention to recovery following a seizure may help to prevent these deaths. This information has important implications for the advice given to those who have a seizure disorder.