Learning Disabilities Service, Norwich Community Health Partnership NHS Trust, Little Plumstead Hospital, Norwich, England.
Epilepsia. 1997 Nov;38(11 Suppl):S70-1. doi: 10.1111/j.1528-1157.1997.tb06134.x.
It is now acknowledged that an excess mortality is associated with epilepsy, over and above that of the underlying disease. This risk is even greater in uncontrolled epilepsy. Because sudden unexplained death in epilepsy (SUDEP) appears to be seizure-related, it is likely that this excess mortality would be reduced if seizures were better controlled or, ideally, stopped. Patients and physicians are in the fortunate position of being able to choose from more effective treatments for epilepsy than at any time in the past. Reductions in mortality, however, must go hand in hand with improved epilepsy care in general. In the past, this area has been overlooked and underfunded. There is some evidence that specialist epilepsy clinics are better at managing cases of epilepsy than general neurology clinics or general medical services. Investing in dedicated epilepsy services could arguably lead to a reduction in mortality. Such investment would also lead to improved provision of counseling and information services for people with epilepsy. It is not yet possible to determine the effects of these interventions or to set targets for a reduction in mortality in people with epilepsy, because there is a lack of accurate data on the prevalence of epilepsy and the rate of SUDEP. Obtaining these figures should perhaps be our first aim. The relevance of these issues to the management of SUDEP are discussed with regard to the United Kingdom Health Service.
现在已经认识到，癫痫患者的死亡率高于基础疾病患者，而且这种风险在未得到控制的癫痫中更高。由于癫痫猝死（SUDEP）似乎与癫痫发作有关，如果癫痫发作得到更好的控制，或者理想情况下停止发作，这种超额死亡率可能会降低。患者和医生有幸能够选择比过去任何时候都更有效的癫痫治疗方法。然而，死亡率的降低必须与一般癫痫护理的改善齐头并进。在过去，这一领域被忽视和资金不足。有一些证据表明，癫痫专科诊所比一般神经病学诊所或一般医疗服务更擅长管理癫痫病例。投资于专门的癫痫服务可以说是降低死亡率的一种方式。这种投资还将改善为癫痫患者提供咨询和信息服务。由于缺乏关于癫痫患病率和 SUDEP 发生率的准确数据，目前还不可能确定这些干预措施的效果，也不可能确定癫痫患者死亡率降低的目标。因此，获得这些数据或许应该是我们的首要目标。本文就英国国民保健服务（NHS）讨论了这些问题对 SUDEP 管理的相关性。
