Abstracts

Rationale: The incidence of sudden unexpected death in epilepsy (SUDEP) varies widely between studies. Most studies base the rate calculations of SUDEP on an estimation of the incidence of epilepsy in the community. We will determine the incidence of SUDEP in the whole Icelandic population, based on identification at forensic autopsy, during a 20 year period. Methods: We included all individuals who were previously diagnosed with epilepsy and died unexpectedly in Iceland from January 1st 1991 through December 31st 2010. Case finding was based on forensic autopsies. Individuals who had epilepsy and died of known causes, e.g. drowning, motor vehicle accident etc. were excluded. The cases were classified according to the definition proposed by Nashef et al. (2012). The incidence of SUDEP was calculated based on the actual number of residents in Iceland during the study period. Results: We identified 33 cases of Definite SUDEP (no other cause of death found at autopsy) and Definite SUDEP Plus (a preexisting condition, known before or after autopsy, could have contributed to the death). There were 23 men and 10 women. The mean age at death was 40 years. Mean duration of epilepsy was 16 years. The incidence of SUDEP was 0.6 per 100,000 person-years for the general population. The incidence rate in the general epilepsy population was 1.2 per 1,000 person-years. Age-specific incidence was highest among those 20-39 years of age (1.0 per 100,000 person-years). SUDEP accounted for 17 (2%) of all 1038 deaths in persons aged between 20-39 years, in the total Icelandic population, during the study period. Conclusions: We report the incidence of SUDEP in the whole Icelandic population. The case finding was based on forensic autopsies in a country with a high rate of autopsies for individuals dying unexpectedly outside hospital. References: Nashef L, So EL, Ryvlin P, Tomson T. Epilepsia. 2012 Feb;53(2):227-33.