Death in epileptic people: a review of Manitoba's medical examiner's cases.

Studies of cause-specific mortality show that deaths of epileptic people can be classified into those directly or indirectly related to epilepsy; those related to the underlying pathology giving rise to epilepsy; and those unrelated to either epilepsy or its causes. In this descriptive retrospective study, medical examiner's cases that occurred in Manitoba, Canada during 2004 were reviewed. One hundred and seventeen cases (4.06%) had epilepsy in their history. Cause of death was related directly to seizure in 12 cases (10.3%) and indirectly in six cases (5.1%); related to underlying pathology giving rise to epilepsy in 33 cases (28.2%); and unrelated to either of them in 60 cases (51.3%). Cause of death was unknown in six cases (5.1%). The causes of death, in order of frequency, were cardiac pneumonia, cerebrovascular accident and seizure disorder. Manner of death was natural in 86 cases (73.5%), accidental in 19 cases (16.2%), suicidal in five cases (4.3%), undetermined in five cases (4.3%) and homicidal in two cases (1.7%). While the mean age of the deceased persons with a positive history of seizure in this study was about 10 years less than those with a negative history of seizure, there was no significant difference between them in the manner of death. Epileptic people are not at greater risk for accidental death or suicide; however they are at greater risk for drowning. Recently diagnosed cases of epilepsy are at greater risk of dying from seizure or underlying pathology during the first year of their disease.