Ictal and Interictal Cardiac Manifestations in Epilepsy. A Review of Their Relation With an Altered Central Control of Autonomic Functions and With the Risk of SUDEP

Mazzola, Laure; Rheims, Sylvain

doi:10.3389/fneur.2021.642645

Cited by 26 publications

(14 citation statements)

References 110 publications

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“…Experimental studies demonstrated that brain lesions in some autonomic regulatory regions prevent immune activation depending on T-cell response [33][34], supporting that parasympathetic and sympathetic drives mediate immune adaptative responses. Ictal and interictal autonomic disturbances can occur in PWE with a possible impact on immune response [35][36][37][38]. Moreover, some data suggest that ASM can directly affect both humoral and cellular immunity, modifying the synthesis and expression of cytokines [12], but the mechanisms are not fully understood and other intercurrent factors may act as confounders.…”

Section: Immune Response In Pwementioning

confidence: 99%

COVID-19 prevalence and mortality in people with epilepsy: A nation-wide multicenter study

Sánchez-Larsen¹,

Conde‐Blanco

Viloria-Alebesque

et al. 2021

Epilepsy & Behavior

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Section: Immune Response In Pwementioning

confidence: 99%

COVID-19 prevalence and mortality in people with epilepsy: A nation-wide multicenter study

Sánchez-Larsen¹,

Conde‐Blanco

Viloria-Alebesque

et al. 2021

Epilepsy & Behavior

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“…The reason for this effort is that the unexplained sudden death in epilepsy (SUDEP) risk, as demonstrated by autopsy and clinical studies, is 0.7-1.3/1000, which is 24 times higher than the normal population, especially in case of idiopathic and cryptogenic epilepsy [21]. Electrical stimulation of different locations within the brain was found to induce dysrhythmia such as tachyarrhythmia, bradyarrhythmia (time to time), asystole (rarely), AV block, and ventricular fibrillation [9,22,23]. Seizures affecting the temporal lobe, insular cortex, and amygdala tend to cause dysrhythmia more frequently [24].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of autonomic nervous system functions by using tilt table test and heart rate variability in epileptic children

REDJEPOV

USTA

YILDIRIM³

et al. 2023

Marmara Medical Journal

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Objective: The value of head-up tilt test (HUTT) for differential diagnosis of epilepsy and the autonomic nervous system functions in epileptic children using heart rate variability (HRV) are studied. Patients and Methods: The study group consisted of 16 children with idiopatic/criptogenic epilepsy and 12 controls. Heart rate, PR interval, corrected QT (QTc) interval, QT and QTc dispersion were calculated using 12-lead electrocardiogram (ECG), HRV analysis was performed using the Holter recordings obtained both during HUTT and throughout the day. Time domain parameters, standard deviation of all RR intervals (SDNN), the standard deviation of mean NN intervals in five-minutes recording (SDANN), mean standard deviation of NN intervals in five-minutes recordings (SDNNi), root mean square of successive differences (RMSSD), count divided by the total number of all NN intervals (pNN50) and frequency domain parameters low frequency (LF), high frequency (HF), lowfrequency/ high-frequency ratio (LF/HF) were calculated in both and compared between the two groups. Results: Head-up tilt test was positive in 4 epileptic children (25%), none of controls were positive. The heart rate of the patients were higher than the controls (p=0.015). LF/HF ratio in 24-hour Holter recordings, were significantly lower (1.13±0.6, 1.83±0.7 respectively, p=0.002); the SDANN during HUTT (28.7±20.2, 18.2 ± 19.9 respectively, p=0.024) were significantly higher in the patients than the controls. Conclusion: Head-up tilt test positivity is frequent in epileptic children, and cannot be used in differential diagnosis. HRV calculated both from 24 hour Holter recordings and Holter recordings under orthostatic stress were impaired in favour of parasympathetic system in epileptic children.

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“…Although these events are related primarily to postictal brainstem dysfunction, it has been suggested that the involvement by the epileptic discharges of cortical areas that participate in breathing and vegetative regulation may also pay a role 62 . Amygdala, peri‐sylvian cortex, including the insula, and the anterior/middle cingulate gyrus are the main cortical nodes of the central autonomic networks, involved in regulation of breathing, cardiac rhythm, and blood pressure 62–64 . Structural and functional magnetic resonance imaging (MRI) studies identified changes in these regions in patients who died from SUDEP and individuals at high risk of SUDEP 65–67 .…”

Section: Factors Potentially Associated With Reduction Of Mortality A...mentioning

confidence: 99%

Drug‐resistant epilepsy and mortality—Why and when do neuromodulation and epilepsy surgery reduce overall mortality

Rheims

Sperling

Ryvlin³

2022

Epilepsia

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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). The impact of epilepsy surgery on mortality has been investigated since the 1970s, with increased interest in this field during the past 15 years. We systematically reviewed studies investigating mortality rate in patients undergoing epilepsy surgery or neuromodulation therapies. The quality of available evidence proved heterogenous and often limited by significant methodological issues. Perioperative mortality following epilepsy surgery was found to be <1%. Meta‐analysis of studies that directly compared patients who underwent surgery to those not operated following presurgical evaluation showed that the former have a two‐fold lower risk of death and a three‐fold lower risk of SUDEP compared to the latter (odds ratio [OR] 0.40, 95% confidence interval [CI]: 0.29–0.56; p < .0001 for overall mortality and OR 0.32, 95% CI: 0.18–0.57; p < .001 for SUDEP). Limited data are available regarding the risk of death and SUDEP in patients undergoing neuromodulation therapies, although some evidence indicates that vagus nerve stimulation might be associated with a lower risk of SUDEP. Several key questions remain to be addressed in future studies, considering the need to better inform patients about the long‐term benefit–risk ratio of epilepsy surgery. Dedicated long‐term prospective studies will thus be required to provide more personalized information on the impact of surgery and/or neuromodulation on the risk of death and SUDEP.

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Ictal and Interictal Cardiac Manifestations in Epilepsy. A Review of Their Relation With an Altered Central Control of Autonomic Functions and With the Risk of SUDEP

Cited by 26 publications

References 110 publications

COVID-19 prevalence and mortality in people with epilepsy: A nation-wide multicenter study

COVID-19 prevalence and mortality in people with epilepsy: A nation-wide multicenter study

Evaluation of autonomic nervous system functions by using tilt table test and heart rate variability in epileptic children

Drug‐resistant epilepsy and mortality—Why and when do neuromodulation and epilepsy surgery reduce overall mortality

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