Is Epilepsy Life Threatening?

^{Reviewed by: My Child Without Limits Advisory Committee September 2009}

Although most people who have epilepsy lead full, active lives, they are also at increased risk for two life-threatening conditions: status epilepticus and sudden unexplained death.

Status Epilepticus

With status epilepticus a person either has an abnormally long seizure or does not fully regain consciousness between seizures. Although there is no strict definition for the time at which a seizure turns into status epilepticus, most people agree that any seizure lasting longer than five minutes should be treated as though it was status epilepticus.

Status epilepticus affects about 195,000 people each year in the United States and results in about 42,000 deaths. While people with epilepsy are at an increased risk for status epilepticus, about 60 percent of people who develop this condition have no previous seizure history. These cases often result from tumors, trauma, or other problems that affect the brain and may by themselves be life-threatening.

Most seizures do not require emergency medical treatment. However, someone with a seizure that lasts more than five minutes may be in status epilepticus. This person should be taken to an emergency room immediately. It is important to treat a person with status epilepticus as soon as possible.

One study showed that 80 percent of people in status epilepticus who received medication within 30 minutes of the beginning of the seizure eventually stopped having seizures. But, only 40 percent recovered if two hours had passed before they received medication. Doctors in a hospital setting can treat status epilepticus with several different drugs and can undertake emergency life-saving measures, such as administering oxygen, if necessary.

People in status epilepticus do not always have severe convulsive seizures. Instead, they may have repeated or prolonged non-convulsive seizures. This type of status epilepticus may appear as a sustained episode of confusion or agitation in someone who does not ordinarily have that kind of mental impairment. While this type of episode may not seem as severe as convulsive status epilepticus, it should still be treated as an emergency.

Sudden Unexplained Death

For reasons that are not well understood, people with epilepsy also have an increased risk of dying suddenly. This condition, called sudden unexplained death, can also occur in people who don't have epilepsy, but it's twice as likely to affect someone who has epilepsy.

Researchers are still unsure why sudden unexplained death occurs. One study suggested that using more than two anticonvulsant drugs might be a risk factor. However, it is not clear whether the use of multiple drugs causes the sudden death, or whether people who use multiple anticonvulsants have a greater risk of death because they have more severe types of epilepsy.

Next:

When Are Seizures Not Epilepsy?

Download the Introduction to Epilepsy.