Vol 16, No 5 (2009)
Review Article
Published online: 2009-07-31
The brain-heart connection: Implications for understanding sudden unexpected death in epilepsy
Cardiol J 2009;16(5):394-399.
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.
Keywords: epilepsysudden cardiac deathheartcentral nervous system