Alcohol consumption and sudden unexpected death in epilepsy: experimental approach

Abstract

-Using the pilocarpine model of epilepsy, we investigated the effects of alcohol consumption on the frequency of seizures in animals with epilepsy as well the underlying a possible association between alcohol intake and sudden unexpected death in epilepsy (SUDEP) occurrence. Rats were divided randomly into two groups: (A) rats with epilepsy and (B) rats with epilepsy that received a daily dose of ethanol solution (350 mg kg -1 , i.p.) for 30 days. The basal frequency of seizures observed in the A and B groups during the first 30 days were 3.4±1.5 and 3.2±1.9 seizures per week per animal, respectively. In B group, it was observed a significant seizure increase (11.6±5.3) during the first 2 weeks of alcohol administration and quite interesting, one rat died suddenly after a generalized tonic-clonic seizure during this period. We concluded in our experimental study that exist a possible association between alcohol abuse and SUDEP occurrence.KEy WoRDS: epilepsy, alcohol, heart, seizure, SUDEP. Consumo de álcool e morte súbita em epilepsia: uma abordagem experimentalResumo -Utilizando o modelo de epilepsia induzido pela pilocarpina, investigamos os efeitos do consumo de álcool sobre a frequência de crises epilépticas em animais com epilepsia, como também uma possível associação entre a ingestão de álcool e ocorrência de morte súbita e inesperada nas epilepsias (SUDEP). os animais foram randomicamente divididos em dois grupos: (A) ratos com epilepsia e (B) ratos com epilepsia que receberam uma dose diária de etanol (350 mg kg -1 , i.p.) por 30 dias consecutivos. A frequência basal de crises epilépticas observadas nos grupos A e B durante os primeiros 30 dias foram de 3,4±1,5 e 3,2±1,9 crises por semana/animal, respectivamente. No grupo B, ocorreu aumento significativo na frequência de crises (11,6±5,3) durante as duas primeiras semanas de administração do álcool e de forma interessante, um animal morreu subitamente após uma crise generalizada tônico-clonica durante esse período. Concluímos em nossa abordagem experimental que existe uma possível associação entre o consumo de álcool e a ocorrência de SUDEP. PAlAvRAS-ChAvE: epilepsia, álcool, coração, crise epiléptica, SUDEP. Epilepsy is one of the most prevalent neurological conditions 1 and people with epilepsy are more likely to die prematurely than those without epilepsy, and the most common epilepsy-related category of death is sudden unexpected death in epilepsy (SUDEP) 1,2 . The cause of SUDEP is still unknown; however, the most commonly suggested mechanisms are cardiac abnormalities during and between seizures 2,3 . Additionally, a number of associated factors for SUDEP have been reported but the results are not wholly consistent between studies. These include refractoriness of the epilepsy, presence of generalized tonic-clonic seizures, polytherapy with antiepileptic

Chronic Alcohol Use and Accompanying Noncommunicable Diseases

“…In elderly patients, the most frequent causes of late-onset epilepsy seem to be cerebrovascular disease, head trauma and alcoholism (53). The findings from an experimental approach study on alcohol consumption and sudden unexpected death in epilepsy revealed that there is a possible association between alcohol abuse and sudden unexpected death in epilepsy (SUDEP) occurrence (54). Furthermore, the findings from a systematic review study of the risk factors associated with the onset and natural progression of epilepsy revealed that family history of epilepsy, history of febrile seizures, alcohol consumption, central nervous system (CNS) and other infections, brain trauma, head injury, perinatal stroke, preterm birth and three genetic markers are associated with the onset of epilepsy (55).…”

Sweet sixteen and never been drunk?

“…Moreover, alcohol use has been shown to be the major cause of non-ischaemic cardiomyopathy in Western society (Papadakis, Ganotakis, & Mikhailidis, 2000). In some high-risk populations such as epileptics, alcohol use is more harmful because it might increase the risk of sudden unexpected death in epilepsy (SUDEP) (Ghaeni, 2008;Gordon & Devinsky, 2001;Hauser, Ng, & Brust, 1988;Rehm et al, 2003a;Scorza et al, 2009). …”