A new report has been published aiming to help doctors struggling to decide when to tell patients suffering from epilepsy that their illness carries with it a risk of death.
Scientists from the Western Infirmary in Glasgow have analysed mortality rates among sufferers of different kinds of epilepsy in order to determine which cases require notification, their results being published today in the Lancet Neurology journal.
By comparing newly diagnosed and chronic epilepsy cases using records covering a two-decade period, the researchers found that patients with chronic epilepsy were nearly twice as likely to die.
"Mortality risks and preventive strategies should be discussed with patients with epilepsy when treatment fails or is refused despite recurrent seizures," the study said.
Striking a balance between a patient's "right not to know" and the importance of understanding the risks in order to maximise attention paid to properly taking their medication lies at the heart of the debate.
With individual patients responding differently to available treatments the matter is further complicated, a variable the scientists fully understood.
"In light of our results, routine discussion of mortality at the time of diagnosis might not be necessary, especially if this does not affect the management of the disorder," the authors said.
"However, mortality risks should be discussed with all patients diagnosed with epilepsy who choose not to take antiepileptic drugs."
One in 20 people will have a seizure at some time in their life, while 456,000 people – equivalent to one in every 131 – suffer from epilepsy in the UK.