Xu Xinwei, Sha Leihao, Basang Sijia, Peng Anjiao, Zhou Xiangyang, Liu Yanxu, Li Yixuan, Chen Lei
Department of Neurology, West China Hospital, Sichuan University, No. 28 Dianxin South street, Chengdu, 610041, Sichuan, China.
Sichuan Provincial Engineering Research Center of Brain-Machine Interface, and Sichuan Provincial Engineering Research Center of Neuromodulation, Chengdu, 610041, Sichuan, China.
J Neurol. 2025 Mar 25;272(4):291. doi: 10.1007/s00415-025-13002-6.
Epilepsy is linked to a significantly higher risk of death, yet public awareness remains low. This study aims to investigate mortality characteristics, to reduce epilepsy-related deaths and improve prevention strategies.
This study systematically reviews mortality data in relevant literature from PubMed and Embase up until June 2024. Data quality is assessed using the Newcastle-Ottawa Scale, and analysis includes trends, regional differences, and the economic impact of premature death. Global Burden of Disease (GBD) data are used to validate trends. In addition, a review of guidelines and expert statements on sudden unexpected death in epilepsy (SUDEP) is included to explore intervention strategies and recommendations.
Annual mortality rates of epilepsy have gradually declined, mainly due to improvements in low-income countries, while high-income regions have experienced an upward trend. Male patients exhibit higher mortality rates than females. Age-based analysis shows that the elderly contributes most to this increase due to chronic conditions such as cardiovascular disease and pneumonia related to epilepsy. This may be a key factor contributing to the increased mortality among epilepsy patients in aging high-income regions. Accidents and suicides are more prevalent in low-income regions. The highest mortality risks occur in the early years post-diagnosis and during prolonged, uncontrolled epilepsy. SUDEP remains a leading cause of death.
This study highlights the impact of gender, region, and disease duration on epilepsy mortality. Future research should focus on elderly epilepsy patients mortality characteristics and personalized interventions for SUDEP.
癫痫与显著更高的死亡风险相关，但公众意识仍然较低。本研究旨在调查死亡率特征，以减少与癫痫相关的死亡并改进预防策略。
本研究系统回顾了截至2024年6月来自PubMed和Embase的相关文献中的死亡率数据。使用纽卡斯尔-渥太华量表评估数据质量，分析包括趋势、地区差异以及过早死亡的经济影响。使用全球疾病负担（GBD）数据来验证趋势。此外，纳入了对癫痫性猝死（SUDEP）的指南和专家声明的综述，以探索干预策略和建议。
癫痫的年死亡率逐渐下降，主要是由于低收入国家的改善，而高收入地区则呈上升趋势。男性患者的死亡率高于女性。基于年龄的分析表明，由于与癫痫相关的心血管疾病和肺炎等慢性疾病，老年人对这一增长的贡献最大。这可能是导致高收入老龄化地区癫痫患者死亡率上升的一个关键因素。事故和自杀在低收入地区更为普遍。最高的死亡风险发生在诊断后的早期以及长期未控制的癫痫期间。SUDEP仍然是主要的死亡原因。
本研究强调了性别、地区和疾病持续时间对癫痫死亡率的影响。未来的研究应关注老年癫痫患者的死亡率特征以及针对SUDEP的个性化干预措施。
