2748 Sudden unexpected death in epilepsy (SUDEP) in New Zealand

ObjectivesTo determine:the incidence of SUDEP in New Zealand;how this changes over time;risk factors associated with SUDEP.MethodsNew Zealand coroners and other sources notify us of people with epilepsy (pwe) who die unexpectedly. Cases are reviewed and assessed according to the Devinsky criteria.ResultsThe study commenced on 01/08/2019.We were notified of 159 pwe who died suddenly during the first 2 years of the study.85 patients died from Definite, Definite-plus, Probable or Probable Plus-SUDEP; (46 in year 1; 39 in year 2); 30 died from Possible SUDEP; 2 further patients died during their first seizure without a formal diagnosis of epilepsy; 40 had an alternative cause of death; the cause of death is still under review in 2 patients.55 of 85 Definite or Probable SUDEP cases were male. 58% were aged between 20 and 50.New Zealand’s estimated population at 30 June 2020 was 5,084,300, giving a crude incidence of SUDEP of at least 8.0/million of population per year. If possible cases are included, then the rate of SUDEP is 10.3/million per yearIf the prevalence of epilepsy in New Zealand is 5.49/1000 people, then the incidence of SUDEP is between 1.52/1000 pwe and 2.06/1000 pwe (including possible SUDEP cases).ConclusionsThe estimated incidence of SUDEP for New Zealand is at least 8.0/million per year of population; much higher than determined by retrospective review. We are continuing to collect prospective data, to determine whether changes in epilepsy management reduce the rate of SUDEP.