People who have epilepsy might be at greater risk of death from unnatural causes — such as accidents and suicide — than those without the condition. This is the finding of a new study recently reported in JAMA Neurology.
Epilepsy, a neurological disorder, is marked by recurrent and spontaneous seizures, which are bouts of abnormal brain activity.
A person is diagnosed with epilepsy if they have at least two seizures. Seizure length varies from person to person, and they can last anywhere from a few seconds to a few minutes.
Between 2.2 and 3 million people in the United States live with epilepsy, and around 1 in 26 will develop the disorder at some point in their lives.
Previous research has found that people with epilepsy are at greater risk of premature death than people without the disorder.
But, Dr. Hayley Gorton — from the School of Health Sciences and the Faculty of Biology, Medicine, and Health at the University of Manchester in the United Kingdom — and colleagues note that few studies have taken an in-depth look at how epilepsy might affect the risk of death from unnatural causes.
Dr. Gorton and colleagues sought to address this research gap by analyzing the data of 936,107 people from England, of whom 44,678 had been diagnosed with epilepsy.
The scientists also analyzed the data of 14,051 people from Wales who had been diagnosed with epilepsy, alongside 279,365 individuals from Wales who were free of the disorder.
More specifically, they evaluated how a diagnosis of epilepsy affects the risk of unnatural causes of death, including suicide, drug overdoses, accidents — such as vehicle crashes — and unintentional and intentional medication poisoning.
Compared with people who did not have epilepsy, individuals with the disorder were found to be at twice the risk of death by suicide and at three times the risk of accidental death.
Also, the study revealed that the risk of death by unintentional medication poisoning was increased by fivefold for people with epilepsy, and they were also 3.5 times more likely to die as a result of intentional medication poisoning.
Interestingly, anti-epileptic drugs only accounted for about 10 percent of medication-related deaths among people with epilepsy. Instead, opioid painkillers and drugs for mental health disorders were most commonly involved in medication-related deaths among people with and without epilepsy.
Dr. Gorton says that the reasons behind the greater risk of unnatural death among individuals with epilepsy are “not fully understood,” but the scientists suggest that it could be down to the “direct consequences of seizures.”
“The mental illness comorbidities associated with epilepsy are also associated with increased risk of unintentional injury and poisoning and suicide,” the researchers add.
Although further research is needed to pinpoint the precise mechanisms behind their findings, Dr. Gorton urges clinicians to warn people with epilepsy about these potential risks so that they can take preventive measures.
“We urge clinicians to advise their patients about unintentional injury prevention and monitor them for suicidal thoughts and behavior,” says Dr. Gorton.
“We would also advise doctors to assess suitability and toxicity of medication when prescribing medicines for other associated conditions to these individuals,” she concludes.