Prevalence of sudden unexpected death among the patients with uncontrolled epilepsy without history of previous epilepsy surgery and under long-term care and monitoring in Kashani hospital, Isfahan, Iran, during the years 2012-2016

Abstract

Background: Epilepsy is a common neurologic disorder in all ages. Sudden unexpected death in epilepsy (SUDEP) is one the prevalent causes of mortality in patient with epilepsy, especially those with chronic type disease. According to the lack of epidemiologic study in Iran, this study aimed to evaluate the prevalence of sudden unexpected death in patients with uncontrolled epilepsy without experience of epilepsy surgery and under long-term care and monitoring during the years 2012-2016. Methods: This was a descriptive epidemiologic study on patients with uncontrolled epilepsy without experience of surgery who were monitored in epilepsy center of Kashani Hospital, Isfahan, Iran, during 2012-2016. Patient's records were given from hospital archives, and evaluated for demographic and epilepsy data. Then, telephone call was made to assess the presence of mortality in patients, and its causes. Findings: 876 patients with epilepsy and mean age of 28.5 ± 11.6 years were evaluated, that 54.2 of them were men. The incidence of mortality and sudden unexpected death in epilepsy among them was 1.5 and 0.7, respectively. The most prevalent type of seizure in patients with sudden unexpected death in epilepsy was automotor with secondary tonic clonic generalization, meanwhile the most common type of seizure in other causes of death was automotor. The most common finding in magnetic resonance imaging (MRI) was normal result in patients with sudden unexpected death in epilepsy, and temporal tumor in patients with other causes of death. The most common epileptogenic zones were right and left temporal in patients with sudden unexpected death in epilepsy, and with other causes of death, respectively. Conclusion: Sudden unexpected death in epilepsy is one of the important causes of death is Iran. There was no risk factor for sudden unexpected death in epilepsy in this study. Temporal lobe epilepsy is the most common epileptogenic zone in patients with sudden unexpected death in epilepsy. © 2018, Isfahan University of Medical Sciences(IUMS). All rights reserved.