Death certificates fail to consistently report sudden unexplained death in epilepsy (SUDEP), making it difficult for researchers to study the phenomenon, according to a recent survey sent to medical examiners (MEs). Among 847 responses on 11 case vignettes, MEs did not use the ICD-10 seizure code in 3% to 62% of cases, depending on the specific vignette. Several factors may be responsible for the shortfall, including the complicated nature of SUDEP and uncertain circumstances involved in any individual death.
Atherton DS, Davis GG, Wright C, Devinsky O, Hesdorffer D. A Survey of medical examiner death certification of vignettes on death in epilepsy: gaps in identifying SUDEP [published online April 21, 2017]. Epilepsy Res. doi: http://dx.doi.org/10.1016/j.eplepsyres.2017.04.013.