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February 11, 2005
Children with Epilepsy Face Little Risk of
Death
A group of Halifax-based researchers studied the causes and
frequency of death in children with epilepsy. They sought to
reassure parents of newly diagnosed epileptics about the
relatively low risk of death associated with the disorder.
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Methods
More than 95 percent of epileptic children in Nova Scotia are
treated by four Halifax-based pediatric neurologists. A single
clinic, the IWK Health Centre, is the only tertiary pediatric
center for the province, and all childhood electroencephalograms
(EEGs) are interpreted there. Researchers were thus able to
acquire records on all children who developed epilepsy in Nova
Scotia during the period from 1977-85.
During a procedure with an electroencephalogram electrodes are
attached to the scalp. Wires attach these electrodes to a
machine which records the electrical impulses. The results are
either printed out or displayed on a computer screen.
Methods
Investigators matched names and birth dates with provincial
health care, death and marriage registries. They examined death
certificates, necropsy (autopsy) reports, and physician records
of children who had died and contacted families if sudden
unexpected death in epilepsy could have occurred. This cohort
was compared with a reference population matched for age and
sex.
Results
Of 692 children with epilepsy, 3.8 percent died. Frequency of
death was 5.3 times higher than in the reference population in
the 1980s and 8.8 times higher in the 1990s. However, the
majority of children with epilepsy who died also had a severe
neurological deficit. The overall rate of death of patients
without a deficit was 0.8 percent, which did not differ
significantly from the reference population.
Conclusions
Researchers found that children with epilepsy have more than
five times the risk of dying than the general population in the
first 15-20 years after diagnosis. Most of these deaths, though,
are related to comorbid (having two or more disorders
simultaneously) neurological disorders and not to the epilepsy.
The authors concluded that the extreme rarity of death of
children without another serious neurological disorder should
offer reassurance to families who have a child with epilepsy.
Source: Lancet 2002; 359: 1891-95. Published online April 16,
2002.
Inquiries:
Dr Carol Camfield, Division of Child Neurology, IWK Health
Centre, Halifax, Nova Scotia B3J 3G9, Canada
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