Abstract
SUMMARY:: There is increasing evidence that periictal respiratory disturbances are an important contributor to the pathophysiological changes leading to sudden unexpected death in epilepsy (SUDEP). In patients with SUDEP occurring in epilepsy monitoring units, respiratory disturbances occurred early in the postictal period and frequently preceded terminal bradycardia and asystole. Periictal hypoxemia and hypercapnia are observed in about one-third of patients undergoing video-EEG telemetry. Pulmonary edema is frequently observed at autopsy in cases of SUDEP and may be relevant as a contributing cause in a subset of SUDEP. Animal studies support the notion that periictal respiratory disturbances are crucial to the pathophysiology of SUDEP. Serotonergic neurons modulate the excitability of the neuronal network generating the respiratory rhythm. Ictal and periictal impairment of serotonergic and glutaminergic neurons involved in the arousal system may also predispose to SUDEP by impeding the patient's ability to reposition the head and facilitate ventilation after a seizure. Periictal functional impairment of serotonergic neurons seems to be important in the pathophysiology of SUDEP and a potential target for pharmacotherapy aimed at SUDEP risk reduction.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 10-13 |
| Number of pages | 4 |
| Journal | Journal of Clinical Neurophysiology |
| Volume | 32 |
| Issue number | 1 |
| DOIs | |
| State | Published - Feb 13 2015 |
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Keywords
- Autonomic
- Pulmonary Edema
- Respiratory
- Review
- Seizures
- SUDEP
ASJC Scopus subject areas
- Clinical Neurology
- Neurology
- Physiology
- Physiology (medical)
Cite this
Respiratory pathophysiology with seizures and implications for sudden unexpected death in epilepsy. / Kennedy, Jeffrey; Seyal, Masud.
In: Journal of Clinical Neurophysiology, Vol. 32, No. 1, 13.02.2015, p. 10-13.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Respiratory pathophysiology with seizures and implications for sudden unexpected death in epilepsy
AU - Kennedy, Jeffrey
AU - Seyal, Masud
PY - 2015/2/13
Y1 - 2015/2/13
N2 - SUMMARY:: There is increasing evidence that periictal respiratory disturbances are an important contributor to the pathophysiological changes leading to sudden unexpected death in epilepsy (SUDEP). In patients with SUDEP occurring in epilepsy monitoring units, respiratory disturbances occurred early in the postictal period and frequently preceded terminal bradycardia and asystole. Periictal hypoxemia and hypercapnia are observed in about one-third of patients undergoing video-EEG telemetry. Pulmonary edema is frequently observed at autopsy in cases of SUDEP and may be relevant as a contributing cause in a subset of SUDEP. Animal studies support the notion that periictal respiratory disturbances are crucial to the pathophysiology of SUDEP. Serotonergic neurons modulate the excitability of the neuronal network generating the respiratory rhythm. Ictal and periictal impairment of serotonergic and glutaminergic neurons involved in the arousal system may also predispose to SUDEP by impeding the patient's ability to reposition the head and facilitate ventilation after a seizure. Periictal functional impairment of serotonergic neurons seems to be important in the pathophysiology of SUDEP and a potential target for pharmacotherapy aimed at SUDEP risk reduction.
AB - SUMMARY:: There is increasing evidence that periictal respiratory disturbances are an important contributor to the pathophysiological changes leading to sudden unexpected death in epilepsy (SUDEP). In patients with SUDEP occurring in epilepsy monitoring units, respiratory disturbances occurred early in the postictal period and frequently preceded terminal bradycardia and asystole. Periictal hypoxemia and hypercapnia are observed in about one-third of patients undergoing video-EEG telemetry. Pulmonary edema is frequently observed at autopsy in cases of SUDEP and may be relevant as a contributing cause in a subset of SUDEP. Animal studies support the notion that periictal respiratory disturbances are crucial to the pathophysiology of SUDEP. Serotonergic neurons modulate the excitability of the neuronal network generating the respiratory rhythm. Ictal and periictal impairment of serotonergic and glutaminergic neurons involved in the arousal system may also predispose to SUDEP by impeding the patient's ability to reposition the head and facilitate ventilation after a seizure. Periictal functional impairment of serotonergic neurons seems to be important in the pathophysiology of SUDEP and a potential target for pharmacotherapy aimed at SUDEP risk reduction.
KW - Autonomic
KW - Pulmonary Edema
KW - Respiratory
KW - Review
KW - Seizures
KW - SUDEP
UR - http://www.scopus.com/inward/record.url?scp=84922608830&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84922608830&partnerID=8YFLogxK
U2 - 10.1097/WNP.0000000000000142
DO - 10.1097/WNP.0000000000000142
M3 - Article
C2 - 25647768
AN - SCOPUS:84922608830
VL - 32
SP - 10
EP - 13
JO - Journal of Clinical Neurophysiology
JF - Journal of Clinical Neurophysiology
SN - 0736-0258
IS - 1
ER -