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https://www.readbyqxmd.com/read/28549245/analysis-of-heart-rate-variability-and-risk-factors-for-sudep-in-patients-with-drug-resistant-epilepsy
#1
Leyla Baysal-Kirac, Nail Güven Serbest, Erdi Şahin, Hava Özlem Dede, Candan Gürses, Ayşen Gökyiğit, Nerses Bebek, Ahmet Kaya Bilge, Betül Baykan
BACKGROUND: Cardiac problems have been suggested as causes of sudden unexpected death in epilepsy (SUDEP). Our aim was to investigate possible associations of cardiac autonomic functions based on heart rate variability (HRV) parameters with risk factors of SUDEP in patients with drug-resistant epilepsy. METHODS: Forty-seven patients with drug-resistant seizures and 45 healthy control subjects were enrolled in the study. Interictal time domain parameters of HRV were evaluated with 24-hour Holter recordings...
May 23, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28464295/obstructive-apnea-due-to-laryngospasm-links-ictal-to-postictal-events-in-sudep-cases-and-offers-practical-biomarkers-for-review-of-past-cases-and-prevention-of-new-ones
#2
Mark Stewart, Richard Kollmar, Ko Nakase, Joshua Silverman, Krishnamurthi Sundaram, Rena Orman, Jason Lazar
Seizure spread into autonomic and respiratory brainstem regions is thought to play an important role in sudden unexpected death in epilepsy (SUDEP). As the clinical dataset of cases of definite SUDEP available for study grows, evidence points to a sequence of events that includes postictal apnea, bradycardia, and asystole as critical events that can lead to death. One possible link between the precipitating seizure and the critical postictal sequence is seizure-driven laryngospasm sufficient to completely obstruct the airway for an extended period, but ictal laryngospasm is difficult to fully assess...
May 2, 2017: Epilepsia
https://www.readbyqxmd.com/read/28460334/maximal-exhaustive-treadmill-test-features-in-patients-with-temporal-lobe-epilepsy-search-for-sudden-unexpected-death-biomarkers
#3
Guilherme L Fialho, Arthur G Pagani, Roger Walz, Peter Wolf, Katia Lin
Autonomic dysfunction may account for sudden unexpected death in patients with epilepsy (PWE). On the other hand, low cardiovascular fitness, which may affect autonomic function, is a risk factor for sudden death and all-cause mortality in the general population. Little is known about autonomic variables and cardiovascular response to exercise in PWE. We submitted thirty consecutive PWE with no known cardiovascular diseases to maximal treadmill test, comparing them with matched controls. All individuals were submitted to clinical assessment, 12-lead electrocardiogram (ECG) and echocardiogram to exclude cardiovascular disease...
April 24, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28456095/a-survey-of-medical-examiner-death-certification-of-vignettes-on-death-in-epilepsy-gaps-in-identifying-sudep
#4
Daniel S Atherton, Gregory G Davis, Cyndi Wright, Orrin Devinsky, Dale Hesdorffer
OBJECTIVE: Lack of standardized terminology on death certificates (DCs) of SUDEP type cases may obscure the presence of epilepsy in these deaths. Most DCs for individuals dying unexpectedly with epilepsy are certified by medical examiners (MEs). The purpose of this study was to gauge death certification practices of MEs when interpreting SUDEP cases and assess implications for valid surveillance of SUDEP. MATERIALS AND METHODS: A survey consisting of clinical vignettes describing deaths in individuals with epilepsy was sent to medical examiners...
April 22, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28438841/practice-guideline-summary-sudden-unexpected-death-in-epilepsy-incidence-rates-and-risk-factors-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology-and-the-american-epilepsy-society
#5
Cynthia Harden, Torbjörn Tomson, David Gloss, Jeffrey Buchhalter, J Helen Cross, Elizabeth Donner, Jacqueline A French, Anthony Gil-Nagel, Dale C Hesdorffer, W Henry Smithson, Mark C Spitz, Thaddeus S Walczak, Josemir W Sander, Philippe Ryvlin
OBJECTIVE: To determine the incidence rates of sudden unexpected death in epilepsy (SUDEP) in different epilepsy populations and address the question of whether risk factors for SUDEP have been identified. METHODS: Systematic review of evidence; modified Grading Recommendations Assessment, Development, and Evaluation process for developing conclusions; recommendations developed by consensus. RESULTS: Findings for incidence rates based on 12 Class I studies include the following: SUDEP risk in children with epilepsy (aged 0-17 years) is 0...
April 25, 2017: Neurology
https://www.readbyqxmd.com/read/28438840/gaining-perspective-on-sudep-the-new-guideline
#6
EDITORIAL
Barbara A Dworetzky, Jaideep Kapur
No abstract text is available yet for this article.
April 25, 2017: Neurology
https://www.readbyqxmd.com/read/28431832/unravelling-the-mysteries-of-sudden-unexpected-death-in-epilepsy
#7
K G Hampel, R Rocamora Zuñiga, C M Quesada
INTRODUCTION: Sudden unexpected death in epilepsy (SUDEP) is the most frequent cause of premature death in epileptic patients. Most SUDEP events occur at night and frequently go unnoticed; the exact pathophysiological mechanisms of this phenomenon therefore remain undetermined. Nevertheless, most cases of SUDEP are attributed to an infrequent yet extremely severe complication of epileptic seizures. DEVELOPMENT: We conducted a systematic literature search on PubMed...
April 18, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28427028/terminal-seizure-frequency-and-its-relation-to-sudep
#8
Deng Chen, Yang Si, Jun He, Ying Deng, Tao Chen, Yu-Jin He, Ling Liu, Dong Zhou
BACKGROUND: Sudden unexpected death in epilepsy (SUDEP) is a major cause of death in patients with epilepsy. Several risk factors have been implicated, including early age of onset, tonic-clonic seizures and antiepileptic drugs. However, whether patients who die from SUDEP have a greater frequency of seizures in the few months before death is unclear. We investigated the terminal seizure frequency and its relation to SUDEP among a large group of patients with tonic-clonic seizures in rural West China...
May 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28427020/experiences-with-premorbid-sudep-discussion-among-participants-in-the-north-american-sudep-registry-nasr
#9
Jay Louik, Kyra Doumlele, Fizza Hussain, Laura Crandall, Jeffrey Buchhalter, Dale Hesdorffer, Elizabeth Donner, Orrin Devinsky, Daniel Friedman
The North American SUDEP Registry (NASR) is a repository of clinical data and biospecimens in cases of sudden unexpected death in epilepsy (SUDEP), a leading cause of epilepsy-related deaths. We assessed whether bereaved families were aware of SUDEP before their family member's death and their preferences for SUDEP disclosure. At enrollment, next-of-kin of SUDEP cases completed an intake interview, including questions assessing premorbid SUDEP discussions. Only 18.1% of the 138 next-of-kin recalled a previous discussion of SUDEP with a healthcare provider or support resource...
May 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28411519/-breaking-good-news-neurologists-experiences-of-discussing-sudep-with-patients-in-scotland
#10
Tom Nisbet, Sue Turbull, Sharon Mulhern, Saif Razvi
Since the findings of a Fatal Accident Inquiry (FAI) in 2010, clinicians working in Scotland have been advised to discuss the risk of Sudden Unexpected Death in Epilepsy (SUDEP) with patients immediately or soon after a diagnosis of epilepsy is made. A thematic analysis was used to describe the experiences discussing SUDEP of 10 clinicians (six Consultant Neurologists and four Neurology Registrars) working in Scotland. Contrary to previous research, clinicians appear to be routinely discussing SUDEP in a standardized fashion with newly diagnosed patients and the FAI appears to have instigated this change in practice...
May 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28410929/applying-ethical-principles-in-discussing-sudep-with-patients-and-families
#11
EDITORIAL
Gabriel M Ronen
No abstract text is available yet for this article.
May 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28384699/sudden-unexpected-death-in-epilepsy-among-patients-with-benign-childhood-epilepsy-with-centrotemporal-spikes
#12
Kyra Doumlele, Daniel Friedman, Jeffrey Buchhalter, Elizabeth J Donner, Jay Louik, Orrin Devinsky
Importance: Children with benign epilepsy with centrotemporal spikes (BECTS) have traditionally been considered to have a uniformly good prognosis. However, benign may be a misnomer because BECTS is linked to cognitive deficits, a more severe phenotype with intractable seizures, and the potential for sudden unexpected death in epilepsy (SUDEP). Objective: To determine if cases of BECTS are present in the North American SUDEP Registry (NASR). Design, Setting, and Participants: The NASR is a clinical and biospecimen repository established in 2011 to promote SUDEP research...
April 3, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28380395/equivocal-significance-of-post-ictal-generalized-eeg-suppression-as-a-marker-of-sudep-risk
#13
Joon Y Kang, Amin H Rabiei, Leslie Myint, Maromi Nei
PURPOSE: Our objective was to determine the significance of PGES as a possible EEG marker of increased risk for SUDEP and explore factors that influence PGES. METHODS: We identified 17 patients who died due to definite or probable SUDEP and 52 living control patients with drug resistant focal epilepsy who underwent EEG monitoring and least one seizure recorded on EEG. We reviewed 305 seizures on EEG and when available, on video, for presence or absence of PGES, the duration of PGES immediately after seizure end, seizure type, state seizure occurred (sleep vs...
March 27, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28334922/scn2a-deletion-improves-survival-and-brain-heart-dynamics-in-the-kcna1-null-mouse-model-of-sudden-unexpected-death-in-epilepsy-sudep
#14
Vikas Mishra, Bharat K Karumuri, Nicole M Gautier, Rui Liu, Timothy N Hutson, Stephanie L Vanhoof-Villalba, Ioannis Vlachos, Leonidas Iasemidis, Edward Glasscock
People with epilepsy have greatly increased probability of premature mortality due to sudden unexpected death in epilepsy (SUDEP). Identifying which patients are most at risk of SUDEP is hindered by a complex genetic etiology, incomplete understanding of the underlying pathophysiology and lack of prognostic biomarkers. Here we evaluated heterozygous Scn2a gene deletion (Scn2a+/-) as a protective genetic modifier in the Kcna1 knockout mouse (Kcna1-/-) model of SUDEP, while searching for biomarkers of SUDEP risk embedded in electroencephalography (EEG) and electrocardiography (ECG) recordings...
June 1, 2017: Human Molecular Genetics
https://www.readbyqxmd.com/read/28323007/inhibition-of-microglial-activation-with-minocycline-at-the-intrathecal-level-attenuates-sympathoexcitatory-and-proarrhythmogenic-changes-in-rats-with-chronic-temporal-lobe-epilepsy
#15
Amol M Bhandare, Komal Kapoor, Kim L Powell, Emma Braine, Pablo Casillas-Espinosa, Terence J O'Brien, Melissa M J Farnham, Paul M Pilowsky
The incidence of sudden unexpected death in epilepsy (SUDEP) is highest in people with chronic and drug-resistant epilepsy. Chronic spontaneous recurrent seizures cause cardiorespiratory autonomic dysfunctions. Pituitary adenylate cyclase-activating polypeptide (PACAP) is neuroprotective, whereas microglia produce both pro- and anti-inflammatory effects in the CNS. During acute seizures in rats, PACAP and microglia produce sympathoprotective effect at the intermediolateral cell column (IML), whereas their action on the presympathetic rostral ventrolateral medulla (RVLM) neurons mediates proarrhythmogenic changes...
March 18, 2017: Neuroscience
https://www.readbyqxmd.com/read/28281492/comorbidities-of-epilepsy
#16
REVIEW
H V Srinivas, Urvashi Shah
In epilepsy management, control of seizures is the prime objective. However, the quality of life is affected by comorbid conditions that include the neurological, neuropsychiatric, and neurobehavioural disorders. These are not only reactive processes to a chronic condition but also have a bidirectional relationship, sharing common underlying pathogenesis. This article besides addressing these issues also explores the therapeutic management. A systematic search of PubMed from Jan 2006 to August 2016 was undertaken using the terms "comorbidities" and "epilepsy...
2017: Neurology India
https://www.readbyqxmd.com/read/28272506/a-murine-model-to-study-epilepsy-and-sudep-induced-by-malaria-infection
#17
Paddy Ssentongo, Anna E Robuccio, Godfrey Thuku, Derek G Sim, Ali Nabi, Fatemeh Bahari, Balaji Shanmugasundaram, Myles W Billard, Andrew Geronimo, Kurt W Short, Patrick J Drew, Jennifer Baccon, Steven L Weinstein, Frank G Gilliam, José A Stoute, Vernon M Chinchilli, Andrew F Read, Bruce J Gluckman, Steven J Schiff
One of the largest single sources of epilepsy in the world is produced as a neurological sequela in survivors of cerebral malaria. Nevertheless, the pathophysiological mechanisms of such epileptogenesis remain unknown and no adjunctive therapy during cerebral malaria has been shown to reduce the rate of subsequent epilepsy. There is no existing animal model of postmalarial epilepsy. In this technical report we demonstrate the first such animal models. These models were created from multiple mouse and parasite strain combinations, so that the epilepsy observed retained universality with respect to genetic background...
March 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28268489/predicting-seizures-in-untreated-temporal-lobe-epilepsy-using-point-process-nonlinear-models-of-heartbeat-dynamics
#18
G Valenza, A Romigi, L Citi, F Placidi, F Izzi, M Albanese, E P Scilingo, M G Marciani, A Duggento, M Guerrisi, N Toschi, R Barbieri
Symptoms of temporal lobe epilepsy (TLE) are frequently associated with autonomic dysregulation, whose underlying biological processes are thought to strongly contribute to sudden unexpected death in epilepsy (SUDEP). While abnormal cardiovascular patterns commonly occur during ictal events, putative patterns of autonomic cardiac effects during pre-ictal (PRE) periods (i.e. periods preceding seizures) are still unknown. In this study, we investigated TLE-related heart rate variability (HRV) through instantaneous, nonlinear estimates of cardiovascular oscillations during inter-ictal (INT) and PRE periods...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28242084/understanding-death-in-children-with-epilepsy
#19
REVIEW
Elizabeth J Donner, Peter Camfield, Linda Brooks, Jeffrey Buchhalter, Carol Camfield, Tobias Loddenkemper, Elaine Wirrell
Death in children with epilepsy is profoundly disturbing, with lasting effects on the family, community, and health care providers. The overall risk of death for children with epilepsy is about ten times that of the general population. However, the risk of premature death for children without associated neurological comorbidities is similar to that of the general population, and most deaths are related to the cause of the epilepsy or associated neurologic disability, not seizures. The most common cause of seizure-related death in children with epilepsy is sudden unexpected death in epilepsy (SUDEP)...
January 31, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28230913/an-unexpected-finding-in-sudep-involving-a-child-focal-myocardial-infarct-adjacent-to-bundle-of-his
#20
Jadee L Neff, Peter T Lin
Sudden unexpected death in epilepsy (SUDEP) is a nontraumatic, nondrowning death of an individual with epilepsy in which an autopsy with appropriate ancillary studies does not identify a cause of death. The mechanism of death in SUDEP is unknown, but is thought to involve cardiac and/or respiratory mechanisms. Research in SUDEP is hindered by a lack of consensus regarding required components of a death investigation before a cause of death may be certified as SUDEP. Histopathologic examination of the cardiac conduction system is not routinely performed in SUDEP death investigations...
February 23, 2017: Journal of Forensic Sciences
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