Editorials

Avoiding premature death in epilepsy

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h718 (Published 10 February 2015) Cite this as: BMJ 2015;350:h718
  1. Leone Ridsdale, professor of neurology and general practice
  1. 1Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, Academic Neuroscience Centre, London SE5 8AF, UK
  1. leone.ridsdale{at}kcl.ac.uk

General practice is the place to start, and much can be done

An estimated 1.16 per 1000 people with epilepsy die suddenly each year.1 In 2013 there were 680 deaths from epilepsy among people aged under 75 (973 deaths at all ages) in England and Wales.2 Sudden death in epilepsy peaks in young adults, particularly men, so a 20 year old with epilepsy has a greater than 1% risk of dying before he reaches 30, before adding other known risks for sudden death. Comparing years of potential life lost from neurological disease, epilepsy is second only to stroke.1 Research on this topic has focused on cohort studies1 and whether risk should be explained to patients.3 However, equally important and currently unanswered questions are: can group and individual risks for death be identified, perhaps using patients’ routine electronic records? Are some identified risks amenable to better medical management? And will cash strapped governments pay for it?

Some deaths are unavoidable, but improved care might result in fewer unnecessary, untimely deaths. General practitioners routinely identify risks of heart disease and stroke in the UK using electronic records and discuss them with patients. National strategy also supports risk identification for cancer in primary care.4

With others, I conducted a …

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