Frequency of Mortality and Sudden Unexpected Death in Patients with Uncontrolled Epilepsy Underwent Epilepsy Surgery in Kashani Hospital, Isfahan, Iran, during the Years 2007 to 2017

Background: Epilepsy is one of the most prevalent neurologic disorders in all ages. Epilepsy surgery is widely prescribed for patients with refractory epilepsy, and can control seizure episodes. Controlling seizures is associated with decrease in mortality in these patients. This study aimed to evaluate the prevalence of sudden unexpected death in epilepsy (SUDEP) in patients with refractory epilepsy underwent epilepsy surgery. Methods: This was a descriptive epidemiologic study on patients with uncontrolled epilepsy underwent epilepsy surgery in Kashani hospital affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, during the years 2007-2017. They were under long term video electroencephalogram (video EEG) monitoring for presurgical evaluation in Kashani hospital epilepsy center. Patient's records were given from hospital archives, and evaluated for demographic and epilepsy data. Then, telephone call was made to assess the presence of mortality in patients and its causes, and the frequency of mortality and sudden unexpected death was calculated. Findings: In this study, 324 patients with refractory epilepsy, who underwent epilepsy surgery, with mean age of 29.2 ± 9.8 years were evaluated; 59.3% of them were men. The total incidence of mortality was 2.3% (3 cases), and none of them were sudden unexpected death. There was significant and non-significant association between incidence of mortality with gender and age, respectively. The causes of death were tumor recurrence (2 cases) and intracranial hemorrhage during the surgery (1 case). Conclusion: The frequency of sudden unexpected death among the epilepsy patients underwent epilepsy surgery in Iran is lower than other countries.