Epilepsy Clinical Trial
Official title:
Risk Factors in Sudden Unexpected Death in Epilepsy of the Adults and Children: A Matched Case-control Study
Numerous studies over the past decade have shown without any doubt that there is a higher
mortality risk in patients with epilepsy than in the general population. The cause of death
may be related to the cause of epilepsy, being directly related to a seizure (status
epilepticus or sudden unexpected death in epilepsy; SUDEP), a consequence of seizures
(accidents, etc), other associated pathologies (cancer, cardiovascular disease, ischemic
heart disease, pneumonia, etc) or an associated disorder (depression or suicide). A SUDEP is
defined as a sudden, non-traumatic, unexpected death in a patient with epilepsy, not
necessarily in the presence of witnesses, that is not due to drowning, with or without
evidence of a seizure, excluding documented status epilepticus and in which a post-mortem
autopsy reveals no anatomical or toxicological cause of death. Little is known about SUDEP
and its mechanisms and risk factors.
This epidemiological study is based on the RSME. The Main objective of this study to
identify risk factors of SUDEP, in particular night-time supervision and the risks
associated with anti-epileptic drugs including compliance and drug interactions.
Numerous studies over the past decade have shown without any doubt that there is a higher
mortality risk in patients with epilepsy than in the general population. The cause of death
may be related to the cause of epilepsy, being directly related to a seizure (status
epilepticus or sudden unexpected death in epilepsy; SUDEP), a consequence of seizures
(accidents, etc), other associated pathologies (cancer, cardiovascular disease, ischemic
heart disease, pneumonia, etc) or an associated disorder (depression or suicide). A SUDEP is
defined as a sudden, non-traumatic, unexpected death in a patient with epilepsy, not
necessarily in the presence of witnesses, that is not due to drowning, with or without
evidence of a seizure, excluding documented status epilepticus and in which a post-mortem
autopsy reveals no anatomical or toxicological cause of death. Little is known about SUDEP
and its mechanisms and risk factors.
A French national network on epilepsy related death (Reseau Sentinelle Mortalité Epilepsie,
RSME) will be initially established in 2010 by the French League Against Epilepsy (LFCE)
under the leadership of bereaved families and supported by the French Foundation for
Epilepsy Research (FFRE). This epidemiological study is based on the RSME.
The Main objective of this study to identify risk factors of SUDEP, in particular night-time
supervision and the risks associated with anti-epileptic drugs including compliance and drug
interactions.
The study design is an epidemiological case-control study. The cases are SUDEP identified in
the RSME and French centres of Epileptology.
Epilepsy-related deaths are reported by physicians but also by bereaved families. An
interview with a psychologist will be proposed at this moment.
The control group will include patients with epilepsy and relatives of patients from
tertiary epilepsy units (in particular, participants of GRENAT registry or a national
multicenter study RESPOMSE), private neurologists or general practitioners and thanks from
patients associations.
Sociodemographic data, lifestyle, personal and family medical history will be collected
during an interview with a psychologist by phone or during a face to face interview. For
bereaved families, information on causes and circumstances of beloved one's death will be
collected during these interviews.The characteristics of epilepsy will be completed by the
patient's neurologist.
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