Department of Neurology, Stavanger University Hospital, Stavanger, Norway.
Seizure. 2012 Oct;21(8):573-7. doi: 10.1016/j.seizure.2012.05.015. Epub 2012 Jun 26.
The reasons why the mortality of patients with epilepsy is significantly increased, even many years after seizure onset, are not fully understood. The aim of this study was to compare the distribution of the causes of death (COD) in an epilepsy population with that in the general population and with previous findings in other epilepsy populations. In addition, we investigated the chronological relationship between the onset of epilepsy and the onset of the diseases leading to death.
The COD for patients who were registered with a diagnosis of epilepsy at Stavanger University Hospital from August 1 1995-July 31 2005 and died during the same period were obtained from the Norwegian Cause of Death Registry and the hospital records were reviewed. The distribution of the corresponding COD in the general population was obtained from Statistics Norway.
At least 6.8% (18/266) of the deaths of epilepsy patients were directly related to seizures. Epilepsy patients who had died from brain tumors (n=46) were excluded from further analysis. Of the remaining 220 deceased epilepsy patients, 39 (17.7%) had died from heart disease, compared with 27.8% in the general population (p<0.001). No other significant differences in the distribution of COD in the epilepsy population and the general population were identified. The majority of the epilepsy patients who died from heart disease (71.8%) and cerebrovascular disease (72%) had cardiovascular disease prior to seizure onset and in at least 43% of those who died from neoplasms the onset of malignancy occurred before the first seizure.
Comorbid diseases and underlying conditions were the major determinants of mortality in this population of epilepsy patients. Conditions that are not caused by epilepsy or its treatment may represent an important explanation for the previously documented excess mortality in people with epilepsy.
尽管癫痫患者在发病多年后死亡率显著升高的原因尚未完全明确，但仍需对此进行研究。本研究旨在比较癫痫患者的死因分布（COD）与普通人群及其他癫痫人群的既往研究结果。此外，我们还研究了癫痫发病与导致死亡的疾病发病之间的时间关系。
从挪威死因登记处和医院病历中获取了 1995 年 8 月 1 日至 2005 年 7 月 31 日期间在斯塔万格大学医院确诊为癫痫且在此期间死亡的患者的 COD，并与普通人群的相应 COD 分布进行比较。
至少有 6.8%（18/266）的癫痫患者的死亡与癫痫发作直接相关。患有脑瘤的癫痫患者（n=46）被排除在进一步分析之外。在剩余的 220 名已故癫痫患者中，有 39 名（17.7%）死于心脏病，而普通人群中这一比例为 27.8%（p<0.001）。在癫痫患者和普通人群中，COD 的分布没有其他显著差异。死于心脏病（71.8%）和脑血管疾病（72%）的大多数癫痫患者在癫痫发作前就患有心血管疾病，而在因恶性肿瘤而死亡的患者中，至少有 43%的人在首次癫痫发作前就已患有恶性肿瘤。
在该癫痫患者人群中，合并症和基础疾病是导致死亡的主要因素。由癫痫或其治疗引起的疾病以外的其他疾病可能是导致既往文献报道的癫痫患者死亡率过高的一个重要原因。
