source: Russell Webster

published: 25 November 2025

Image Credit: Pexels/Duda at Pexels.com

A new (24 November 2025) Learning Lessons bulletin from the Prisons & Probation Ombudsman summarises research from PPO investigations from the past ten years where a prisoner’s death was caused by epilepsy or the prisoner was diagnosed with epilepsy. Our research found the care prisoners with epilepsy receive could be improved and highlights areas requiring further work.

Context and data:

To understand the learning from epilepsy-related deaths in prisons, the PPO team considered three categories of death types.

• Group 1: Where the primary cause of the prisoner’s death was epilepsy (as recorded in the post-mortem) (25 cases). 
• Group 2: Where the secondary cause of the prisoner’s death was epilepsy (as recorded in the post-mortem) (12 cases). 
• Group 3: Where the prisoner was diagnosed with epilepsy, but their primary or secondary cause of death was not epilepsy-related (88 cases).

In the past 10 years, the PPO has investigated 125 deaths that fell into one of these three categories. For each group, the PPO report and clinical review was analysed.

Key findings:

The PPO research has identified the following areas that need to be explored further: 

The number of SUDEPs is higher in prison than in the community. 

It is estimated that sudden and unexpected deaths in epilepsy (SUDEPs) make up around 0.15% of deaths a year in the UK. From post-mortem reports of deaths in prisons from the past 10 years, 0.64% of deaths in prison were SUDEPs. 

The diagnosis of epilepsy within prisons could be improved. 

In 11% of the cases from group 1 and 2 (where the primary or secondary cause of death was epilepsy) the prisoner had not been diagnosed with epilepsy. 

There is a lower remission rate in prison than in the community.  

From the 125 death investigations, the PPO found only 18% had not experienced a seizure in the past year, 56% had, and for the remaining 26% of prisoners it was unclear.

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