Childhood Epilepsy & Death
People, both family members and observers, often are extremely frightened when seeing a child during a convulsive seizure, especially when cyanosis [skin turning blue due to a lack of oxygen in the blood] occurs. Especially during a first seizure, many parents fear that their child is dying. Many continue to think that there is a real possibility of death during subsequent seizures.
A recent study in Nova Scotia of children with epilepsy shows that death of children from epilepsy is rare if they have no underlying functional neurological deficit. Although some children with epilepsy may also have physical or neurological disorders which may cause death, the researchers wanted to assess risk factors and the frequency of death specifically due to epilepsy, so that parents may be counselled appropriately and realistically, and be reassured.
Dr. Carol Camfield and colleagues at the Division of Child Neurology, IWK Health Centre (Halifax, Nova Scotia) conducted a population-based cohort study of children in Nova Scotia who developed epilepsy between 1977-85. Researchers examined the effects of gender, age, epilepsy type and other neurological disorders in reference to data about deaths among the children with epilepsy, and compared these data with those collected from a reference population matched for age and gender.
They found 26 of 692 (3.8%) children with epilepsy died. The frequency of death was approximately 5 times higher than in the reference population of the 1980s, and approximately 9 times higher than in the reference population of the 1990s. Death occurred in 1 of 97 (1%) children with absence epilepsy, 12 of 510 (2%) children with partial and primary generalized epilepsy, and 13 of 85 (15%) children with secondary generalized epilepsy. Of these 26 deaths, 22 were due to disorders sufficient to cause neurologic deficit, 2 were by suicide, 1 was by homicide, and 1 was probably by sudden unexpected death in epilepsy (SUDEP).
Neurologic deficit was the only independent determinant of death.
The investigators concluded that, although there is a slightly increased risk of death in people with childhood-onset epilepsy, most the deaths are related to severe neurological functional deficits and not to the seizures themselves. Rather than using the diagnosis of remote symptomatic epilepsy, the presence of a severe neurological deficit is a simpler way to indicate children who may be at increased risk of death.
Children with remote symptomatic epilepsy but with no neurological deficit are very unlikely to die from epilepsy.
They hope that these findings will help physicians and families who care for children with seizures to allay an enormous worry.
Source
http://image.thelancet.com/extras/01art3267web.pdf
