The mystery of sudden death: Mechanisms for risks

Lathers, Claire M.; Schraeder, Paul L.; Bungo, Michael W.

doi:10.1016/j.yebeh.2007.09.016

Cited by 65 publications

(24 citation statements)

References 197 publications

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“…Importantly, the activation of the hippocampus in temporal lobe epilepsy has been associated with neuronal discharges onto cardiac sympathetic and vagal neurons, resulting in arrhythmia. 61 In the present study, we administered a scant 100 pmol of domoic acid directly into ventral hippocampus. Although we cannot rule out the spread of the neurotoxin into adjacent regions, preliminary evidence collected using telemetry confirms a rapid appearance of ictal activity in the contralateral cortex with concomitant disturbance in electrocardiography, suggesting that it is the spread of electrical discharge, and not the toxin itself, that drives autonomic disturbances.…”

Section: Discussionmentioning

confidence: 96%

Ischemic Cardiomyopathy Following Seizure Induction by Domoic Acid

Vranyac-Tramoundanas

Harrison

Sawant

et al. 2011

The American Journal of Pathology

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Exposure to the excitotoxin domoic acid (DOM) has been shown to produce cardiac lesions in both clinical and animal studies. We have previously shown that DOM failed to directly affect cardiomyocyte viability and energetics, but the development of this cardiomyopathy has remained unexplained. The present study compared effects of high-level seizure induction obtained by intraperitoneal (2 mg/kg) or intrahippocampal (100 pmol) bolus administration of DOM on development of cardiac pathologies in a rat model. Assessment of cardiac pressure derivatives and coronary flow rates revealed a significant time-dependent decrease in combined left ventricular (LV) systolic and diastolic function at 1, 3, 7, and 14 days after intraperitoneal administration and at 7 and 14 days after intrahippocampal DOM administration. LV dysfunction was matched by a similar time-dependent decrease in mitochondrial respiratory control, associated with increased proton leakage, and in mitochondrial enzyme activities. Microscopic examination of the LV midplane revealed evidence of progressive multifocal ischemic damage within the subendocardial, septal, and papillary regions. Lesions ranged from reversible early damage (vacuolization) to hypercontracture and inflammatory necrosis progressing to fibrotic scarring. Plasma proinflammatory IL-1␣, IL-1␤, and TNF-␣ cytokine levels were also increased from 3 days after seizure induction. The observed cardiomyopathies did not differ between intraperitoneal and intrahippocampal groups, providing strong evidence that cardiac damage after DOM exposure is a consequence of a seizure-evoked autonomic response.

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Section: Discussionmentioning

confidence: 96%

Ischemic Cardiomyopathy Following Seizure Induction by Domoic Acid

Vranyac-Tramoundanas

Harrison

Sawant

et al. 2011

The American Journal of Pathology

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“…Adult male Wistar rats (n=20, 220-280 g) were housed under standard controlled conditions (7:00 a.m./7:00 p.m. light/ dark cycle; [20][21][22] o C; 45-55% humidity) with food and water ad libitum. Rats were divided randomly into two groups: (A) rats with epilepsy (n=10), (B) rats with epilepsy that received a daily dose of 3.0 g kg -1 of a 30% ethanol solution via an oesophagic probe for 30 days (n=10).…”

Section: Methodsmentioning

confidence: 99%

“…In this sense, it has been demonstrated an increase of mean heart rate and arrhythmias after heavy drinking, suggesting an exaggerated sympathetic reaction in these events 18,19 . Similarly, cardiac arrhythmia precipitated by seizure discharge acting via the autonomic nervous system has been postulated as a cause of SUDEP 20 . This may include stress related release of catecholamines from the adrenal medulla predisposing to cardiac arrhythmias changes in the autonomic control of the heart [20][21][22][23][24] .…”

Section: Figure Frequency Of Spontaneous Recurrent Seizures (Srss) Dmentioning

confidence: 99%

“…Similarly, cardiac arrhythmia precipitated by seizure discharge acting via the autonomic nervous system has been postulated as a cause of SUDEP 20 . This may include stress related release of catecholamines from the adrenal medulla predisposing to cardiac arrhythmias changes in the autonomic control of the heart [20][21][22][23][24] . Third, the increased frequency of seizures mediated by alcohol administration described in our study could also be related with synaptic integration and plasticity of new neurons in the hippocampal formation.…”

Section: Figure Frequency Of Spontaneous Recurrent Seizures (Srss) Dmentioning

confidence: 99%

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Alcohol consumption and sudden unexpected death in epilepsy: experimental approach

ScorzaI

Cysneiros

Arida

et al. 2009

Arq. Neuro-Psiquiatr.

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-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

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“…Ictal period: Several studies have assessed the frequency and character of ictal cardiac rhythm during seizures (Stollberger and Finsterer, 2004;Ryvlin et al, 2006;Lathers et al, 2008) and compelling evidence exists for the presence of ictal arrhythmias (Ryvlin et al, 2006). For instance, Nashef et al (1996) recorded non-invasively ictal cardiorespiratory variables in patients with epilepsy.…”

Section: Possible Cardiac Abnormalities Related To Sudden Unexpected mentioning

confidence: 99%

Fish consumption, contaminants and sudden unexpected death in epilepsy: many more benefits than risks

Cysneiros

Arida²,

Machado

et al. 2010

Braz. J. Biol.

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People with epilepsy have an increased risk of dying prematurely and the most common epilepsy-related category of death is sudden unexpected death in epilepsy (SUDEP). SUDEP is mainly a problem for patients with chronic uncontrolled epilepsy. The ultimate goal of research in SUDEP is to develop new methods to prevent it and actions other than medical and surgical therapies that could be very useful. Nutritional aspects, i.e., omega-3 fatty acids deficiency, could have an interesting role in this scenario. Some animal and clinical studies have suggested that omega-3 fatty acids could be useful in the prevention and treatment of epilepsy and hence SUDEP. It has been ascertained that the only foods that provide large amounts of omega-3 are seafood (fish and shellfish); however, some fish are contaminated with methylmercury, which may counteract the positive effects of omega-3 fatty acids. Our update review summarises the knowledge of the role of fish consumption on epilepsy research.Keywords: epilepsy, omega-3, heart, sudden death, fish consumption. Consumo de peixe, contaminantes e morte súbita em epilepsia: mais benefícios do que riscos ResumoPessoas com epilepsia têm um risco aumentado de morrer de forma prematura e a causa mais comum de morte relacionada à epilepsia encontra-se na categoria de morte súbita inesperada em epilepsia (SUDEP). SUDEP é um problema significativo para pacientes com epilepsia crônica não controlada. O principal objetivo nas pesquisas em SUDEP é o desenvolvimento de métodos capazes de levar à sua prevenção e ações outras que não medicamentosas e cirúrgicas que podem ser úteis. Os aspectos nutricionais, como por exemplo, a deficiência do ácido graxo ômega-3 pode ter um papel interessante neste cenário. Alguns estudos animais e clínicos têm sugerido que os ácidos graxos ômega-3 podem ser úteis na prevenção e no tratamento da epilepsia e, consequentemente, na SUDEP. Os únicos alimentos que contêm grandes proporções de ômega-3 são os frutos do mar (peixes e mariscos). No entanto, alguns peixes podem estar contaminados com metilmercúrio, o que pode levar a um efeito contrário ao benefício trazido pelos ácidos graxos ômega-3. Aqui, resumimos o conhecimento do papel do consumo de peixe nas pesquisas em epilepsia.Palavras-chave: epilepsia, ômega-3, coração, morte súbita, consumo de peixe.

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The mystery of sudden death: Mechanisms for risks

Cited by 65 publications

References 197 publications

Ischemic Cardiomyopathy Following Seizure Induction by Domoic Acid

Ischemic Cardiomyopathy Following Seizure Induction by Domoic Acid

Alcohol consumption and sudden unexpected death in epilepsy: experimental approach

Fish consumption, contaminants and sudden unexpected death in epilepsy: many more benefits than risks

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