Parental and physician beliefs regarding the provision and content of written sudden unexpected death in epilepsy (SUDEP) information.

Authors:
Neti A Gayatri
Neti A Gayatri
The Leeds Teaching Hospitals NHS Trust
Vivek Jain
Vivek Jain
San Francisco General Hospital
United States
Pawan Kashyape
Pawan Kashyape
Southampton University Hospital
Southampton | United Kingdom
Karen Pysden
Karen Pysden
The Leeds Teaching Hospitals NHS Trust
United Kingdom
Colin Ferrie
Colin Ferrie
The Leeds Teaching Hospitals NHS Trust
United Kingdom

Epilepsia 2010 May 7;51(5):777-82. Epub 2010 Jan 7.

Department of Paediatric Neurology, The Leeds Teaching Hospitals NHS Trust, UK.

Purpose: The 2007 UK National Institute for Health and Clinical Excellence (NICE) guidelines for epilepsy recommend disclosing the risk of sudden unexpected death in epilepsy (SUDEP) to patients. This recommendation is not undertaken routinely, and considerable variation in individual physician practice exists. Literature indicates wariness of causing distress and anxiety, particularly to children/young people and their families through disclosing a nonpreventable risk. There has been no systematic pediatric study examining parent/guardian information needs and beliefs for risk of SUDEP and its impact on seizure management. It is important to first address these concerns before routinely imparting SUDEP information to parents following NICE recommendations.

Methods: Two questionnaire surveys: a questionnaire examining the provision by pediatric neurologists of SUDEP information, and questionnaires examining parental beliefs and implications at two time points regarding SUDEP information provided in a leaflet. Participants were included in the study if their child had an established diagnosis of epilepsy. Factors for exclusion were single unprovoked seizure, absence seizures, patients in remission, and active discontinuation of treatment.

Results: The majority (74%) of pediatric neurologists provided SUDEP information only to a select group of children with epilepsy and were uncertain about the effect such information would have upon the parent and child. Conversely, 91% of parents expected the pediatric neurologist to provide SUDEP risk information. The provision of this information did not have a significant immediate and longer-term negative impact.

Discussion: The majority of parents wanted to know about SUDEP and its associated risks. Whenever possible, SUDEP information should be given by the physician accompanied by an information leaflet.

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May 2010
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