Respiratory findings in sudden unexpected death in epilepsy: a point of convergence for clinical pulmonologists and neurologists

Scorza, Fúlvio A.; Albuquerque, Marly de; Cavalheiro, Ésper Abrão

doi:10.1590/s1806-37132009000600015

J. bras. pneumol.

2009

DOI: 10.1590/s1806-37132009000600015

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Respiratory findings in sudden unexpected death in epilepsy: a point of convergence for clinical pulmonologists and neurologists

Fúlvio A. Scorza

Marly de Albuquerque

Ésper Abrão Cavalheiro

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2016

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“…Thus, possible preventive strategies such as good control of seizures, reduction of stress, participation in physical activity and sports, dietary management (e.g., omega-3 supplementation) and supervision at night are already well formed 46 . Besides these aspects, a close convergence between neurologists and other medical specialties, especially cardiologists, it must also be present in the context and constantly encouraged by experts in the SUDEP field 41,47,48 . Considering the guidelines, we agree with suggestions that patients with epilepsy, especially those at highest risk of SUDEP, should follow the comprehensive cardiovascular screening protocols (ECG, Holter-monitoring, echocardiography, genetic analysis, ergometric exercise test and myocardial scintigraphy, and, if abnormalities were found, coronary angiography) 41,49,50 .…”

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confidence: 99%

Sudden cardiac death in epilepsy disappoints, but epileptologists keep faith

Scorza

Cavalheiro

Costa

2016

Arq. Neuro-Psiquiatr.

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Sudden cardiac death in epilepsy disappoints, but epileptologists keep faithApesar do desapontamento com a morte súbita cardíaca nas epilepsias, os epileptologistas mantêm a fé The first formal description of sudden cardiac death (SCD) was made as early as 4 th century BC by the father of medicine, Hippocrates of Kos, which stated in his aphorisms that those who are subject to frequent and severe fainting attacks without obvious cause die suddenly 1,2 . Presently, in most textbooks SCD is defined as an unexpected death occurring within one hour from onset of symptoms in an individual with stable clinical conditions before the onset of the life-threatening arrhythmic event 3,4,5 . The magnitude of the problem is reflected on the fact that more than 7 million lives per year are lost to SCD worldwide 1 . In Europe, approximately 350,000 individuals die each year due to SCD with unsuccessful out-of-hospital cardiopulmonary resuscitation 6,7 . The incidence of SCD in the United States ranges between 180,000 and 450,000 cases annually, depending on the definition used 4,5,8,9,10 . In a more specific way, prospective studies using multiple sources developed in the United States, Netherlands, Ireland, and China have shown that SCD rates ranging from 50 to 100 per 100 000 in the general population 10,11,12,13,14,15,16 . The global burden of SCD remains high despite the fact that several factors have already been described which increase the risk of SCD in the general population 9,10 . It should not be ignored that epilepsy and seizures can have a profound effect on cardiovascular function and in some cases may be fatal 17,18 . A number of questions should be raise to elucidate clearly the exact relationship between SCD and epilepsy.WHERE? Epilepsy is one of the most common neurological conditions affecting at least 65 million people worldwide 19,20 . Individuals of all ages can be affected by it. It is treatable but often requires lifelong medication and sometimes surgery to control seizures 21,22 . Despite this, seizures in up to 40% of people with epilepsy do not respond properly to antiepileptic drugs or other treatments 23 . In these individuals with refractory epilepsy, high rates of premature death compared with the general population have recorded 24,25 . Sudden unexpected death in epilepsy (SUDEP) is a major cause of death in those people 26 . WHAT? The lack of autopsy results and AbStrACtSudden unexpected death in epilepsy (SUDEP) is the most common cause of death in people with intractable epilepsy. Probably, optimization of seizure control will prevent some of these deaths. Briefly, we integrated in this paper some data about the epidemiology, risk factors, etiology, and preventative measures in the management of SUDEP.Keywords: epilepsy; death, sudden. reSumoA morte súbita nas epilepsias (SUDEP) é a causa mais comum de morte em indivíduos com epilepsia refratária. Provavelmente, o controle das crises epilépticas irá evitar algumas dessas mortes. Resumidamente, nós descrevemos nesse artigo alguns dados sobr...

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confidence: 99%

Sudden cardiac death in epilepsy disappoints, but epileptologists keep faith

Scorza

Cavalheiro

Costa

2016

Arq. Neuro-Psiquiatr.

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Respiratory findings in sudden unexpected death in epilepsy: a point of convergence for clinical pulmonologists and neurologists

Cited by 1 publication

References 6 publications

Sudden cardiac death in epilepsy disappoints, but epileptologists keep faith

Sudden cardiac death in epilepsy disappoints, but epileptologists keep faith

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