Epilepsy-related mortality: A cross-sectional study in a tertiary center in Riyadh, Saudi Arabia

Objective: People with epilepsy (PWE) have higher likelihood of dying prematurely compared to the general population. However, data on epilepsy mortality in some regions of the world are deficient or completely absent. The aim of this study was to investigate epilepsy-related deaths in PWE in a tertiary care center in Riyadh, Saudi Arabia. Methods: PWE who expired in the period from 2016 to 2020 at King Abdulaziz Medical City in Riyadh, Saudi Arabia were included. Demographic data, epilepsy classification, and causes of death were retrieved from the patients’ electronic medical records, and death certificates. Death causes were classified based on Devinsky's classification. Results: We found that 145 PWE died during the study period. The median age at death was 66 years, with an interquartile range of 49–78. Half of the patients who died were male (50.3 %). Of the 145 deaths, 93 (64.1 %) were unrelated to epilepsy, 27 (18.6 %) were due to underlying neurological disease, 15 (10.3 %) were directly due to epilepsy, 7 (4.8 %) were indirectly due to epilepsy, and 3 (2.1 %) were due to acute symptomatic seizures. Sudden unexpected death in epilepsy (SUDEP) has never been recorded as a cause of death in any of the cases. Significance: Epilepsy-related deaths are largely overlooked by physicians who document death certificates. More efforts are needed to increase awareness among physicians about SUDEP and epilepsy-related mortality.