Epileptic seizures, also known as "epilepsy", are significantly more common in children than in adults. The incidence of epilepsy in children is significantly higher than that in adults. Sudden seizures are often a cause of fear for many parents. Some parents will politely ask: Is this disease life-threatening?

In fact, judging from foreign reports, the answer is: yes. But we don't have to be too scared, this accidental death rate is very low, with a rate of 0.22 / 1000 for children and 1.2 / 1000 for adults, which is significantly higher. What factors put patients at risk of sudden death?

The first is the type of seizure; the number of generalized tonic seizures is directly proportional to the risk, especially when there is a sustained status epilepticus, where prolonged seizures can lead to a massive depletion of cerebral oxygen and eventually cerebral hypoxia. How can this be prevented? Both doctors and family members, or the patients themselves, need to be strict in the management of medication, as well as diet and regular living, to reduce the number of such generalized tonic seizures.

Second, is the timing of the seizure, which also increases the risk if the generalized tonic seizure occurs at night, and respiratory depression is a major mechanism for sudden unexpected death. This requires the family to be more observant of the patient at night, with the occurrence of nocturnal generalized tonic seizures.

There are also patients who have never been treated with antiepileptic drugs, children with impaired intelligence, and so on are also risk factors for unexpected sudden death. It is important for people with epilepsy to pay more attention to this group of people and to understand the dangers that risk factors pose to patients.

References:

1．Harden C, Tomson T, Gloss D ,et al.Practice guideline summary: Sudden unexpected death in epilepsy incidence rates and risk factors.Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Epilepsy Curr. 2017 ,17(3):180-187.

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The development of epilepsy disorders does not have a direct impact on a patient's life expectancy. There are also few cases of epileptic patients dying as a result of epilepsy itself; deaths of epileptic patients due to epilepsy tend to be due to accidental deaths of epileptic patients, accidents (e.g., falls from heights, drowning, car accidents, etc.) and cardiac arrhythmias. For the epilepsy community as a whole, the life expectancy of epileptic patients is not fundamentally different from that of the general population; in short, epilepsy does not affect the length of a patient's life.

　　Epilepsy is a common disorder of the nervous system, caused by abnormal discharges of neurons in the brain, a chronic recurrent transient brain dysfunction syndrome. The disease runs in families and may additionally be associated with central nervous system pathologies such as chromosomal abnormalities, focal or diffuse brain disorders, etc. Seizures do not normally result in death unless severe grand mal seizures persist.

　　According to the type of seizure, it is divided into epilepsy generalized tonic-clonic seizure, simple partial seizure, complex seizure, disorientation seizure and status epilepticus. Theoretically, if persistent status epilepticus for 20 minutes, it will cause cerebral cortex hypoxia; persistent seizures seizures for 60 minutes, the hippocampus, nucleus pulposus, cerebellum, thalamus and other cells will also be damaged one after another, followed by dysfunction, cardiorespiratory failure, etc.; if the persistent status epilepticus is more than 13 hours, the hypoxic and ischemic brain damage lasts for too long, and then it will lead to death by organ failure, which is rarely seen, accounting for only 0.1% of epilepsy. Except for status epilepticus, other seizure types are generally not fatal.

　　The cause of sudden death in epileptic patients is not the epilepsy disease itself, but may be due to accidents caused during a seizure when there is a loss of consciousness, such as falling down the stairs, stumbling, drowning, or asphyxiation caused by a garment blocking the nasal passage. Especially during a seizure in the elderly, it is important to take precautions to prevent sudden falls that can cause cerebral hemorrhage or cerebral thrombosis, as well as to move away from dangerous equipment or objects around the person with epilepsy. In persistent status epilepticus, care must be taken to protect the patient's tongue to avoid tongue bite, as well as to avoid respiratory obstruction status.

Sudden epileptic death is probably the most common form of death in people with epilepsy and is associated with epilepsy. In the medical profession, if a person with epilepsy meets with an unexpected death under normal circumstances, which is not related to an accident and for which no other cause can be found, even if an autopsy is performed, it is recognized as a sudden epileptic death.

Sudden death in epilepsy is not common, but it is something that can happen.

1. The incidence is about 1 in 1,000.

2. People with epilepsy who have poorly controlled seizures are relatively more likely to die from sudden epileptic death. For example, 9% of patients requiring epilepsy surgery die from sudden epileptic death.

3. Sudden death in epilepsy is rare in children.

4. The deceased is usually found in bed and face down, with no signs of convulsive seizures.

5. However, one-third of cases of sudden death in epilepsy show that the patient had a seizure before death.

6. The cause of death in sudden epileptic death is still unclear, and some researchers believe that seizures can cause heart arrhythmias, breathing problems, and problems in the brain or other parts of the body.

Usually not, seizures can cause other unintentional injuries. It is better to control the seizures from the root cause.

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