Is Epilepsy Life Threatening?
Although most people who have epilepsy lead full, active lives, individuals with epilepsy are also at increased risk for two life-threatening conditions: status epilepticus and sudden unexplained death.
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. Emergency medical intervention should be sought if a seizure is persisting more than 5 minutes. In some cases, this may mean calling 911. In other cases, this may mean initiating a “seizure plan” which may include giving certain medications. It is important to treat a person with status epilepticus as soon as possible. In most patients with status epilepticus, treatment is effective at stopping the seizure. However this is not always true and efforts to stop the seizure have been shown to be more effective when initiated early. Emergency medical teams can treat status epilepticus with several different drugs and can undertake emergency life-saving measures, such as administering oxygen. The setting in which certain drugs can be used varies. In some situations, parents may be taught to give a medication for status epilepticus, an EMT may be certified to use certain medications. Other medications might only be given in an emergency room or an intensive care unit. 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 cognitive 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 although such events are still very rare. 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.
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