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In this issue of Neurology, two groups using complementary methods report findings relevant to mortality in epilepsy. In one study, Strauss et al.1 used a population-based approach to further refine our understanding of epilepsy’s effect per se on mortality by applying person-time methodology in a population of California residents with mild developmental disabilities. In the other study, Tigaran et al.2 used a patient-based approach, performing extensive cardiovascular examinations on a small cohort of individuals with refractory epilepsy. This latter group’s goal was to identify a mechanism for sudden unexplained death in epilepsy (SUDEP) in this high-risk population. Both approaches contribute to understanding excess mortality in epilepsy overall and SUDEP specifically.
Within the cohort of California residents with mild developmental disabilities, Strauss et al.1 estimated epilepsy’s impact on this population’s mortality rate by comparing the mortality rate of patients with a history of epilepsy with the mortality rate of patients with no history of epilepsy. A strength of their approach was that person-time was used as the unit of study. Thus, if a patient shifted from actively having seizures to having only a remote history of seizures during his period of participation in the cohort, the time he contributed to the cohort could be allotted to each …
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