Clinical Scorecard: Mortality Associated With Epilepsy in Children and Adolescents
At a Glance
Category
Detail
Condition
Clinical topic addressed by the source article: Mortality Associated With Epilepsy in Children and Adolescents
Key Mechanisms
The authors discuss severe early-onset epilepsy syndromes, SUDEP, comorbidities, medication adherence difficulties, care-transition deficiencies, and structural barriers to epilepsy care as possible explanations for mortality patterns; the study did not establish their role or causality.
Target Population
Population described in the source article.
Care Setting
Care setting described in the source article.
Key Highlights
There were 4,472 epilepsy-related deaths among US individuals aged 0 to 19 years from 1999 through 2023.
The overall age-adjusted mortality rate rose from 0.2 per 100,000 population in 1999 to 0.4 per 100,000 in 2023.
Overall mortality increased annually by 5.6% from 2001 through 2023 after remaining stable from 1999 to 2001.
Mortality increased among adolescents aged 11 to 19 years by 8.6% annually from 2008 through 2023; mortality among children aged 10 years or younger was stable overall.
Among children aged 2 years or younger, mortality increased annually by 4.9% from 2001 through 2023.
Guideline-Based Recommendations
Diagnosis
Management
The authors state that age-specific strategies to reduce epilepsy-related mortality are needed.
The article describes SUDEP as occurring most frequently among people with poorly controlled generalized tonic-clonic seizures; it does not provide treatment recommendations.
Monitoring & Follow-up
Risks
SUDEP is described as a leading cause of epilepsy-related death and as occurring most frequently among people with poorly controlled generalized tonic-clonic seizures.
The authors discuss medication adherence difficulties during adolescence, comorbidity burden, care-transition deficiencies, and structural barriers to care as possible explanations; the study did not establish these as causes.
Patient & Prescribing Data
US children and adolescents aged 0 to 19 years; 56% of deaths were among boys and 55% among individuals aged 11 to 19 years.
The study did not evaluate treatments or prescribing. The discussion notes medication adherence difficulties during adolescence as a possible contributor to mortality trends.
Clinical Best Practices
The study was cross-sectional and used aggregated mortality data; it did not establish causes of the observed trends.
The authors note that death certificates may have led to underestimation of epilepsy-related deaths and that the data lacked patient-level information on comorbidities.
Racial and ethnic analyses were limited to non-Hispanic Black and non-Hispanic White individuals because counts or estimates for other groups were insufficient for reliable analysis.
by Naum Shaparin, Rafi Khandaker, Jan Schwarz, Ali Bordbar Jahantighi, Lorenz Droege, Tina Ramishvili, Constance Rippel, Steven C. Lindo, Itay Tokatly Latzer, Jerry Chao, Ibraheem M. Karaye
