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Epilepsy and premature death

Only the Scandinavians do beautiful cohort studies. A total of 245 children with epilepsy were followed for 40 years from 1964. Sixty (24%) died, including half of those with chronic refractory epilepsy. The overall adjusted mortality was three times higher than expected. Children with a demonstrable symptomatic cause were three times more likely to die than those with idiopathic or cryptogenic epilepsy. Six deaths were drownings. Sudden unexplained death in epilepsy (SUDEP) was suspected in 18, giving a cumulative SUDEP risk over 40 years of a sobering 7%.

Migraines: dots and clots

Migraine with aura is associated with white matter hyperintensities and subclinical infarction. A large study (n=780) showed that any severe headache increases white matter hyperintensity load (OR 2.0 (95% CI 1.3 to 3.1); …

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