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Cited by 282Epilepsy research and treatmentPharmacological Effects and Toxicity StudiesDiet and metabolism studies

Mortality of Epilepsy in Developed Countries: A Review

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Forsgren, Lars, Hauser, W. Allen, Olafsson, Elias, Sander, J. W. A. S., Sillanpää, Matti, Tomson, Torbjörn·2005·Epilepsia
DOI 10.1111/j.1528-1167.2005.00403.x
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Abstract

Summary: Mortality in people with epilepsy has been studied in many different populations. In population‐based incidence cohorts of epilepsy with 7–29 years follow‐up, there was up to a threefold increase in mortality, compared to the general population (standardized mortality ratios [SMR] ranged from 1.6 to 3.0). When studies include selected epilepsy populations where patients with frequent and severe seizures are more common, the mortality is even greater. Relative survivorship (RS) following the diagnosis of epilepsy was 91%, 85%, and 83% after 5, 10, and 15 years, respectively. In a population with childhood‐onset epilepsy, RS was 94% and 88% after 10 and 20 years. The level of increased mortality is affected by several factors. In idiopathic epilepsy where the causes of seizures are unknown, the results are conflicting. There was no significant increase in mortality in studies from Iceland, France, and Sweden, a barely increased risk in a study from the United Kingdom, and a significantly increased risk in a study from the United States. In contrast, all studies report a significant increased mortality in remote symptomatic epilepsy (standardized mortality ratios [SMRs] ranging from 2.2 to 6.5). The highest mortality is found in patients with epilepsy and neurodeficits present since birth, including mental retardation or cerebral palsy (SMRs ranging from 7 to 50). Mortality is also affected by age, with the highest SMRs in children, the combined effect of low mortality in the reference population, and high mortality in children with neurodeficits and epilepsy. The highest excess mortality is found in the elderly, ≥75 years. A pronounced increase in mortality is found during the first year following the onset of seizures due to underlying severe diseases. The increased mortality remains in different studies 2–14 years following diagnosis. Most of the factors responsible for the increased mortality are related to the underlying disorder causing epilepsy with pneumonia, cerebrovascular disease, and neoplastic disorders (risk remains elevated when primary brain tumors are excluded), as the most frequently recorded causes. The most common direct seizure‐related cause of death in adolescents and young adults is sudden unexpected death, which is 24 times more common than in the general population.

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Authors
Forsgren, L., Hauser, W. A., Olafsson, E., Sander, J. W. A. S., Sillanpää, M., & Tomson, T.
Affiliations
  • University Hospital of Umeå (SE)
  • Columbia University (US)
  • National Hospital for Neurology and Neurosurgery (GB)
  • University of Turku (FI)
  • Karolinska Institutet (SE)
Corresponding author
Forsgren, Lars
ORCID
Venue
Epilepsia
Publisher
Wiley
Published
2005-12
Volume
46
Issue
s11
Pages
18-27
ISSN
  • 0013-9580 (ISSN-L)
  • 1528-1167
DOI
10.1111/j.1528-1167.2005.00403.x
OpenAlex
W2000871849
Cited by
282
References
60
Citations by year
2026: 4 · 2025: 10 · 2024: 14 · 2023: 10 · 2022: 6 · 2021: 14 · 2020: 36 · 2019: 11 · 2018: 6 · 2017: 15 · 2016: 10 · 2015: 23 · 2014: 17 · 2013: 14 · 2012: 22
FWCI
5.44
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 13 d)
Locations
  • Epilepsia (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Hirsla (Landspítali University Hospital) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
Keywords
epilepsy mortality, standardized mortality ratio, relative survival, idiopathic epilepsy, symptomatic epilepsy, childhood-onset epilepsy, neurodevelopmental disorders, cerebral palsy, intellectual disability, sudden unexpected death in epilepsy, seizure-related death, comorbidities, older adults, age differences in mortality
MeSH terms
Adolescent, Adult, Cause of Death, Child, Cross-Cultural Comparison, Death, Sudden, Epilepsy, Humans, Mortality, Terminology as Topic, Prognosis, Risk Factors, Seizures, Incidence, Survival Analysis, Age Distribution, Sex Distribution, Developed Countries

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