Discussion on the following paper published in the July 2012 issue of DMCN, volume 54, issue 7, pages 612-617 entitled 'Risk and causes of death in children with a seizure disorder'
Authors: Victoria Nesbitt, Martin Kirkpatrick, Gale Pearson, Allan Colvers, Rob Forsyth
DOI: 10.1111/j.1469-8749.2012.04295.x

Aim To describe the frequency and causes of death in children with epilepsy, ascertain the contribution of seizure disorder to cause of death, and compare with rates of sudden unexplained death in children without epilepsy.

Awareness of the increased mortality of people with epilepsy and the need for appropriate counselling has grown in the past decade. In the UK a 2002 National Sentinel Clinical Audit of Epilepsy-Related Deaths was particularly influential. It emphasized a risk of premature death for people with epilepsy of two to three times that of the general population, and suggested that most premature deaths are in the context of seizures. It particularly emphasized the phenomenon of sudden unexpected death in epilepsy (SUDEP) and the risk factors for SUDEP in adults, which were poor seizure control, nocturnal seizures, abrupt and frequent changes in medication, and non-adherence to treatment.