Devinsky O, et al. – For this research, the physicians determined the definite and potential frequency of seizures and epilepsy as a cause of death (COD) and how often this goes unrecognized. They found definite or possible sudden unexpected deaths in epilepsy (SUDEPs) in 72% (18/25) vs 24% (6/25) by the multidisciplinary group (6/15 cases they identified with epilepsy) among the 25 patients identified with epilepsy by the epileptologists. In 5/14 patients with alcohol–related seizures, the epileptologists identified acute symptomatic seizures as a potential COD. Epilepsy was underdiagnosed among decedents. Seizures and SUDEP often went unrecognized as a potential or definite COD among patients with seizures and epilepsy who die suddenly.

• From the population-based San Francisco POST SCD Study, the physicians collected prospective determination of seizures or epilepsy and final COD for individuals aged 18–90 years with out-of-hospital sudden cardiac deaths (SCDs).
• In this study, they compared prospective seizure or epilepsy diagnosis and final COD as adjudicated by a multidisciplinary committee (pathologists, electrophysiologists, and a vascular neurologist) vs retrospective adjudication by 2 epileptologists with expertise in seizure-related mortality.

• The physicians identified 541 SCDs during the 37-month study period (mean age 62.8 years, 69% men).
• Out of them, 525 (97%) were autopsied; 39/525 (7.4%) had seizures or epilepsy (mean age: 58 years, range: 27-92; 67% men), comprising 17% of 231 nonarrhythmic sudden deaths.
• The multidisciplinary team recognized 15 cases of epilepsy, 6 sudden unexpected deaths in epilepsy (SUDEPs), and no deaths associated with acute symptomatic seizures.
• The epileptologists recognized 25 cases of epilepsy and 8 definite SUDEPs, 10 possible SUDEPs, and 5 potential cases of acute symptomatic seizures as a COD.