Article
Clinical Neurology
Yassine Lamrani, Thi Phuoc Yen Tran, Denahin Hinnoutondji Toffa, Manon Robert, Arline-Aude Berube, Dang Khoa Nguyen, Elie Bou Assi
Summary: This study explored the changes in heart rate variability (HRV), heart rate (HR), and breathing rate (BR) during focal seizures and assessed the risk of SUDEP. The results showed that autonomic abnormalities were observed during focal seizures and impaired awareness seizures, which may indicate an increased risk of SUDEP.
FRONTIERS IN NEUROLOGY
(2023)
Article
Behavioral Sciences
Fedele Dono, Giacomo Evangelista, Stefano Consoli, Giovanna Scorrano, Martina Di Pietro, Maria Vittoria De Angelis, Massimiliano Faustino, Raffaella Franciotti, Francesca Anzellotti, Marco Onofrj, Valerio Frazzini, Catello Vollono, Stefano L. Sensi
Summary: This study found that women with catamenial C1-type TLE showed significant reductions in HRV parameters during the menstrual phase, indicating a decrease in vagal output. This suggests that these patients may be at a higher risk of developing cardiac dysfunctions and SUDEP during the menstrual phase.
EPILEPSY & BEHAVIOR
(2022)
Review
Clinical Neurology
Sylvain Rheims, Mickael R. Sperling, Philippe Ryvlin
Summary: Patients with drug-resistant epilepsy have an increased mortality rate, with the majority of deaths being epilepsy related and 40% due to sudden unexpected death in epilepsy (SUDEP). Epilepsy surgery has been found to reduce the risk of death and SUDEP, although the quality of available evidence is variable.
Review
Neurosciences
Enes Akyuz, Arda Kaan Uner, Betul Koklu, Alina Arulsamy, Mohd. Farooq Shaikh
Summary: Epilepsy is a debilitating disorder affecting nearly 70 million people globally, with potential comorbidities such as autonomic nervous system dysfunction and cardiorespiratory impairments. While channelopathies and seizure-induced damages in ANS-control brain structures could contribute to these comorbidities, neurotransmitter/receptor dysfunction and synaptic changes in the ANS may also play a role, especially in drug-resistant patients. Further research is needed to elucidate the pathological mechanisms underlying these cardiorespiratory findings in epilepsy.
JOURNAL OF NEUROSCIENCE RESEARCH
(2021)
Article
Behavioral Sciences
Hiago Murilo Melo, Jefferson Luiz Brum Marques, Guilherme Loureiro Fialho, Peter Wolf, Katia Lin, Roger Walz
Summary: This study aimed to compare heart rate variability (HRV) in patients with drug-resistant mesial temporal lobe epilepsy (MTLE) with healthy controls and analyze the predictive clinical and sociodemographic variables for HRV. The results showed a significant reduction in HRV indices in patients with MTLE compared to controls, with disease duration negatively associated with HRV indices.
EPILEPSY & BEHAVIOR
(2022)
Article
Behavioral Sciences
Jane J. Ding, Peter Liu, Hillary Rebernig, Ana Suller-Marti, Andrew G. Parrent, Jorge G. Burneo, Robert R. Hammond, Lee-Cyn Ang, Qi Zhang
Summary: This study investigated the morphological characteristics of brainstem nuclei in patients with refractory epilepsy after chronic VNS therapy, finding no significant differences in neuronal cell number, degree of astrocytosis, or neuroinflammation in the main brainstem vagal afferent nuclei between VNS+ and VNS- patients.
EPILEPSY & BEHAVIOR
(2021)
Article
Neurosciences
Antis G. George, Jordan S. Farrell, Roberto Colangeli, Alexandra K. Wall, Renaud C. Gom, Mitchell T. Kesler, Cristiane Rodriguez de la Hoz, Bianca R. Villa, Tefani Perera, Jong M. Rho, Deborah Kurrasch, G. Campbell Teskey
Summary: Epilepsy is a potentially fatal disease, and sudden unexpected death is the leading cause of epilepsy-related mortality. It has been found that vasoconstriction and insufficient blood supply during seizures may play a role in sudden death. By using specific drugs to prevent seizure-induced vasoconstriction, the life of patients can be extended, providing a proof-of-principle for prevention of sudden death.
Review
Clinical Neurology
Rosalie Marchal, Sylvain Rheims
Summary: The Autonomic Nervous System (ANS) plays a vital role in regulating many physiological functions. This review discusses the available data and objective tests on epilepsy-related autonomic dysfunction. Epilepsy is associated with an imbalance between the sympathetic and parasympathetic systems, and objective tests have shown alterations in heart rate, baroreflex function, cerebral autoregulation, sweat glands activity, thermoregulation, gastrointestinal and urinary function. Further research is needed to understand interictal ANS function and its potential association with clinically-relevant complications, such as Sudden Unexpected Death In Epilepsy (SUDEP).
NEUROPHYSIOLOGIE CLINIQUE-CLINICAL NEUROPHYSIOLOGY
(2023)
Article
Clinical Neurology
Enes Akyuz, Zuleyha Doganyigit, Ece Eroglu, Franco Moscovicz, Amalia Merelli, Alberto Lazarowski, Jeronimo Auzmendi
Summary: Uncontrolled repetitive generalized tonic-clonic seizures are the main risk factor for sudden unexpected death in epilepsy. These seizures can induce cardiac dysfunction and lead to terminal cardiac arrhythmia, potentially contributing to SUDEP, through mechanisms involving hypoxic stress, neural-cardiac injury, and accumulation of hemosiderin in the heart. Therapeutic strategies targeting cardiac iron overload may reduce the risk of SUDEP in patients with refractory epilepsy.
FRONTIERS IN NEUROLOGY
(2021)
Article
Behavioral Sciences
Kyle C. Rossi, Jonathan M. Gursky, Trudy D. Pang, Mandip S. Dhamoon
Summary: The study found a significant association between epilepsy and status epilepticus events and increased odds of subsequent cardiac arrhythmia or cardiac arrest over multiple chronic timeframes. Enhanced cardiac surveillance may be necessary to reduce morbidity and mortality in patients with epilepsy.
EPILEPSY & BEHAVIOR
(2021)
Article
Neurosciences
Ahmed N. Sahly, Michael Shevell, Lynette G. Sadleir, Kenneth A. Myers
Summary: The underlying pathophysiology of sudden unexpected death in epilepsy (SUDEP) is likely multifactorial, with genetic factors playing a significant role. Evidence suggests that individuals with certain genetic causes of epilepsy may have an increased risk of SUDEP compared to the overall epilepsy population.
AUTONOMIC NEUROSCIENCE-BASIC & CLINICAL
(2022)
Article
Clinical Neurology
Laura do Nascimento Vinholes, Alexandre Sousa da Silva, Eduardo Marinho Tassi, Glenda Correa Borges de Lacerda
Summary: This study found that patients with frontal lobe epilepsy have impaired heart rate variability, increasing the risk of sudden death. Sleep has a protective effect for both patients and controls, with significant increases in heart rate variability parameters observed in the control group during sleep. Correlation analysis with SUDEP-7 scores showed that 24-hour time-domain parameters and LF were inversely correlated with SUDEP-7, with stronger correlations seen with sleep parameters.
ACTA NEUROLOGICA SCANDINAVICA
(2021)
Review
Clinical Neurology
Ann Mertens, Paul Boon, Kristl Vonck
Summary: The experience with neurostimulation for childhood epilepsy is limited compared to adults, but these techniques could be valuable for the developing brain. Vagus nerve stimulation (VNS) has been extensively studied in children and has shown similar safety and efficacy as in adults. Deep brain stimulation (DBS) and responsive neurostimulation (RNS) have shown promise in reducing seizure frequency with low complications in children, but more research is needed. Non-invasive techniques like transcranial direct current stimulation have shown promising but inconsistent results in small trials for childhood epilepsy.
DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY
(2023)
Article
Behavioral Sciences
Andrew C. Schomer, Valentina Baljak, Morgan Lynch, Matthew Clark, Jaideep Kapur
Summary: Alterations in cardiac electrical conduction are common complications of seizures, primarily driven by autonomic dysregulation. This prospective study used 6-lead continuous ECG monitoring to analyze heart rate patterns in the postictal period of hospitalized patients with epilepsy. Out of 117 analyzed seizures in 45 patients, 61% showed an increase in heart rate, while 38.5% exhibited a decline (deceleration). Waveform analysis of 6-lead ECGs revealed PR prolongation in seizures associated with postictal bradycardia.
EPILEPSY & BEHAVIOR
(2023)
Review
Behavioral Sciences
Marina Trivisano, Lorenzo Muccioli, Alessandro Ferretti, Hsiu-Fen Lee, Ching-Shiang Chi, Francesca Bisulli
Summary: The risk of sudden unexpected death in epilepsy (SUDEP) in children is influenced by various factors, including the severity and treatment of epilepsy. Factors such as seizure frequency, type, especially nocturnal generalized tonic-clonic seizures (GTCS), and resistance to anti-seizure medication can predispose patients to SUDEP. SUDEP may be caused by respiratory, cardiovascular, and central autonomic dysfunctions. Genetic mutations in cardiac channelopathy genes may increase the risk of seizure-induced arrhythmias. Night-time supervision can reduce the risk of SUDEP. Reconsidering safety protocols and using seizure detection devices can help reduce the risk of death in epilepsy patients.
EPILEPSY & BEHAVIOR
(2022)
