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This is the Medscape Medical Minute. I'm Dr. George Lundberg.

It makes sense that people subject to seizures would be more likely to drown than those who are not. Five investigators in London, using meta-analytic methods, calculated standardized mortality ratios (SMRs) with 95% confidence intervals for 51 cohorts of people with epilepsy for whom the number of deaths by drowning could be estimated. Reporting in the journal Neurology in 2008,[1] they compared these with the total population by person-years at risk. Four point seven drowning deaths were expected for the general population in that time period, but 88 were observed in the epilepsy population, giving a huge SMR of 18.7. Further breakdown showed an SMR of 18 in prevalent epilepsy, 25.7 in epilepsy and learning disability, 41 in those who had been treated with temporal lobe excision, and 97 in those in institutional care. The lesson is obvious. Persons with epilepsy should not be put in harm's way for possible drowning.

This article is selected from Medscape Best Evidence.[2] I'm Dr. George Lundberg.



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