Increased mortality persists in drug-resistant epilepsy

From Clinical Neurology News, 24 February 2014:

Drug-resistant epilepsy is associated with a significant increase in mortality that persists for decades after diagnosis, particularly among individuals with a known etiology, according to data from a retrospective, multicenter cohort study.

Dr. Brian Callaghan of the University of Michigan, Ann Arbor, and his colleagues identified 433 patients with drug-resistant epilepsy, which was defined as one or more seizures per month for 3 months prior to inclusion and failure on at least two antiepileptic drugs prior to the index date.

The authors said that a consensus exists, based on previous studies, that patients with epilepsy have increased mortality, compared with the general population. However, these studies also suggest that this mortality decreases over time.

“Ours is a prevalent cohort of drug-resistant epilepsy, and mortality was evaluated after the period of increased mortality risk in an incident cohort with epilepsy (i.e., the first 5 years after diagnosis),” the investigators wrote in their report.

“In our study, we also demonstrate increased mortality. Thus, in this group with a median duration of epilepsy at entry of 25 years, elevated mortality persists.”

Over the 6-year follow-up period, there were 33 deaths (7.6%). However, in patients with a known etiology, the case fatality rate was 10.1%, compared with 5.1% among patients with unknown etiology, the researchers reported (J. Neurol. Neurosurg. Psychiatry 2014 Feb. 19 [doi:10.1136/jnnp-2013-307074]). Read more.

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