open access

Vol 16, No 5 (2009)
Review articles
Published online: 2009-07-31
Submitted: 2013-01-14
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The brain-heart connection: Implications for understanding sudden unexpected death in epilepsy

Fulvio A. Scorza, Ricardo M. Arida, Roberta M. Cysneiros, Vera C. Terra, Eliza Y.F. Sonoda, Marly de Albuquerque, Esper A. Cavalheiro
Cardiol J 2009;16(5):394-399.

open access

Vol 16, No 5 (2009)
Review articles
Published online: 2009-07-31
Submitted: 2013-01-14

Abstract

Epilepsy is one of the commonest neurological problems worldwide. Approximately 3% of the general population will suffer from epilepsy at some point in their lives. Unfortunately, individuals with epilepsy are at a higher risk of death than the general population, and sudden unexpected death in epilepsy (SUDEP) is the most important direct epilepsy-related cause of death. Information concerning risk factors for SUDEP is conflicting, but potential risk factors include young age, early onset of epilepsy, duration of epilepsy, uncontrolled seizures, seizure frequency, antiepileptic drug number and winter temperatures. Although the cause of SUDEP is still unknown, its most commonly suggested mechanisms are cardiac abnormalities during and between seizures. As the anatomical substrate of epileptic activity in the central nervous system shows a direct relation to cardiovascular alterations, this may suggest that patients with epilepsy associated with focal central nervous system lesions may face a particular risk of SUDEP. Currently, experimental and clinical data supports the importance of specific brain structures in the behavioural manifestation, the initiation and the propagation of seizures. Regarding the above findings, our research group focused on this review article that SUDEP could be related to the occurrence of specific brain structure dysfunction or anatomical change, at least in some cases.

Abstract

Epilepsy is one of the commonest neurological problems worldwide. Approximately 3% of the general population will suffer from epilepsy at some point in their lives. Unfortunately, individuals with epilepsy are at a higher risk of death than the general population, and sudden unexpected death in epilepsy (SUDEP) is the most important direct epilepsy-related cause of death. Information concerning risk factors for SUDEP is conflicting, but potential risk factors include young age, early onset of epilepsy, duration of epilepsy, uncontrolled seizures, seizure frequency, antiepileptic drug number and winter temperatures. Although the cause of SUDEP is still unknown, its most commonly suggested mechanisms are cardiac abnormalities during and between seizures. As the anatomical substrate of epileptic activity in the central nervous system shows a direct relation to cardiovascular alterations, this may suggest that patients with epilepsy associated with focal central nervous system lesions may face a particular risk of SUDEP. Currently, experimental and clinical data supports the importance of specific brain structures in the behavioural manifestation, the initiation and the propagation of seizures. Regarding the above findings, our research group focused on this review article that SUDEP could be related to the occurrence of specific brain structure dysfunction or anatomical change, at least in some cases.
Get Citation

Keywords

epilepsy; sudden cardiac death; heart; central nervous system

About this article
Title

The brain-heart connection: Implications for understanding sudden unexpected death in epilepsy

Journal

Cardiology Journal

Issue

Vol 16, No 5 (2009)

Pages

394-399

Published online

2009-07-31

Bibliographic record

Cardiol J 2009;16(5):394-399.

Keywords

epilepsy
sudden cardiac death
heart
central nervous system

Authors

Fulvio A. Scorza
Ricardo M. Arida
Roberta M. Cysneiros
Vera C. Terra
Eliza Y.F. Sonoda
Marly de Albuquerque
Esper A. Cavalheiro

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