Patients With Epilepsy Who Die Suddenly Have Cardiac Disease

Abstract

Our results support the hypothesis that patients with epilepsy who die suddenly and unexpectedly have cardiac pathologic conditions that may be responsible for their deaths.

Cardiac electrographic and morphological changes following status epilepticus: Effect of clonidine

“…Structural changes have been reported in 33% of epileptic patients 4 with evidence of fibrosis, reversible myocyte vacuolisation, leukocytic infiltration and oedema found post-mortem. [34][35][36] In our seizure model, interstitial oedema was clearly observed in all ventricular planes and nuclear vacuolisation, an early marker of reversible ischaemic damage, was visible in the saline-KA hearts which is consistent with previous findings. 14,23 Surprisingly, interstitial fibrosis, resembling that observed soon after isoproterenol administration in a rat model, 23 could be found encapsulating the necrotic regions as early as 48 hours after the original insult.…”

Cardiac electrographic and morphological changes following status epilepticus: Effect of clonidine

“…Structural changes have been reported in 33% of epileptic patients 4 with evidence of fibrosis, reversible myocyte vacuolisation, leukocytic infiltration and oedema found post-mortem. [34][35][36] In our seizure model, interstitial oedema was clearly observed in all ventricular planes and nuclear vacuolisation, an early marker of reversible ischaemic damage, was visible in the saline-KA hearts which is consistent with previous findings. 14,23 Surprisingly, interstitial fibrosis, resembling that observed soon after isoproterenol administration in a rat model, 23 could be found encapsulating the necrotic regions as early as 48 hours after the original insult.…”

Progressive development of cardiomyopathy following altered autonomic activity in status epilepticus

“…The cardiac pathology in the present study demonstrates features similar to those described in both animal and clinical studies of seizures (31,46,49). Structural myocardial changes have been reported in 33% of epileptic patients, with evidence of fibrosis, reversible myocyte vacuolization, leukocytic infiltration, and edema observed postmortem (31,49).…”

Improved cardiac outcomes with combined atenolol and diazepam intervention in seizure

“…The QTc interval (~30%‐40%) was also prolonged in these animals at 10‐14 days post‐SE and was associated with an increased risk of aconitine‐induced arrhythmias. The cardiac pathology reported here is also similar to the presentations reported in both animal and clinical studies . Structural changes have been found in 33% of hearts from epileptic patients with evidence of perivascular and interstitial fibrosis, reversible myocyte vacuolization, leukocytic infiltration, and edema discovered at postmortem .…”

Cardiac electrographic and morphological changes following status epilepticus: Effect of clonidine

“…Structural changes have been reported in 33% of epileptic patients 4 with evidence of fibrosis, reversible myocyte vacuolisation, leukocytic infiltration and oedema found post-mortem. [34][35][36] In our seizure model, interstitial oedema was clearly observed in all ventricular planes and nuclear vacuolisation, an early marker of reversible ischaemic damage, was visible in the saline-KA hearts which is consistent with previous findings. 14,23 Surprisingly, interstitial fibrosis, resembling that observed soon after isoproterenol administration in a rat model, 23 could be found encapsulating the necrotic regions as early as 48 hours after the original insult.…”

Progressive development of cardiomyopathy following altered autonomic activity in status epilepticus

“…The cardiac pathology in the present study demonstrates features similar to those described in both animal and clinical studies of seizures (31,46,49). Structural myocardial changes have been reported in 33% of epileptic patients, with evidence of fibrosis, reversible myocyte vacuolization, leukocytic infiltration, and edema observed postmortem (31,49).…”

Improved cardiac outcomes with combined atenolol and diazepam intervention in seizure

“…The QTc interval (~30%‐40%) was also prolonged in these animals at 10‐14 days post‐SE and was associated with an increased risk of aconitine‐induced arrhythmias. The cardiac pathology reported here is also similar to the presentations reported in both animal and clinical studies . Structural changes have been found in 33% of hearts from epileptic patients with evidence of perivascular and interstitial fibrosis, reversible myocyte vacuolization, leukocytic infiltration, and edema discovered at postmortem .…”

Cardiac electrographic and morphological changes following status epilepticus: Effect of clonidine

“…Structural changes have been reported in 33% of epileptic patients 4 with evidence of fibrosis, reversible myocyte vacuolisation, leukocytic infiltration and oedema found post-mortem. [34][35][36] In our seizure model, interstitial oedema was clearly observed in all ventricular planes and nuclear vacuolisation, an early marker of reversible ischaemic damage, was visible in the saline-KA hearts which is consistent with previous findings. 14,23 Surprisingly, interstitial fibrosis, resembling that observed soon after isoproterenol administration in a rat model, 23 could be found encapsulating the necrotic regions as early as 48 hours after the original insult.…”

Progressive development of cardiomyopathy following altered autonomic activity in status epilepticus

“…The cardiac pathology in the present study demonstrates features similar to those described in both animal and clinical studies of seizures (31,46,49). Structural myocardial changes have been reported in 33% of epileptic patients, with evidence of fibrosis, reversible myocyte vacuolization, leukocytic infiltration, and edema observed postmortem (31,49).…”

Improved cardiac outcomes with combined atenolol and diazepam intervention in seizure

“…The QTc interval (~30%‐40%) was also prolonged in these animals at 10‐14 days post‐SE and was associated with an increased risk of aconitine‐induced arrhythmias. The cardiac pathology reported here is also similar to the presentations reported in both animal and clinical studies . Structural changes have been found in 33% of hearts from epileptic patients with evidence of perivascular and interstitial fibrosis, reversible myocyte vacuolization, leukocytic infiltration, and edema discovered at postmortem .…”