Mechanisms of Sudden Unexplained Death in Epilepsy

Overview

Journal Curr Opin Neurol

Specialty Neurology

Date 2015 Mar 4

PMID 25734955

Citations 15

Authors

Alica M Goldman

Affiliations

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Abstract

Purpose Of Review: Human and experimental research has identified cardioautonomic and respiratory dysfunction as a frequent accompaniment in human and animal model events of sudden unexpected death in epilepsy (SUDEP). This review aims to provide an overview of the scientific evidence behind the currently accepted risk factors and working hypotheses regarding SUDEP pathophysiology.

Recent Findings: Epidemiological analysis of public health burden of SUDEP has shown that it rates second only to stroke in the years of potential life lost. Clinical and experimental studies uncovered the dynamic cardiorespiratory dysfunction interictally and imminently to SUDEP, and model systems have facilitated discoveries in SUDEP mechanistic understanding and application of pilot therapeutic interventions. Pilot molecular profiling of human SUDEP has uncovered complex genomic structure in the candidate gene network.

Summary: Extensive clinical and experimental work has established a rationale for the conceptual thinking about SUDEP mechanisms. The application of the global molecular profiling will be invaluable in unraveling the individually unique genomic complexities and interactions that underlie the physiological signature of each patient. At the same time, sophisticated model systems will be critical in the iterative translation of human genetics, physiology, pharmacological interventions, and in testing preventive interventions.

Citing Articles

channelopathy: arrhythmia, cardiomyopathy, epilepsy and beyond.

Remme C Philos Trans R Soc Lond B Biol Sci. 2023; 378(1879):20220164.

PMID: 37122208 PMC: 10150216. DOI: 10.1098/rstb.2022.0164.

Sudden unexpected death in epilepsy: A critical view of the literature.

Giussani G, Falcicchio G, La Neve A, Costagliola G, Striano P, Scarabello A Epilepsia Open. 2023; 8(3):728-757.

PMID: 36896633 PMC: 10472423. DOI: 10.1002/epi4.12722.

Sudden unexpected death in epilepsy: Respiratory mechanisms.

Teran F, Bravo E, Richerson G Handb Clin Neurol. 2022; 189:153-176.

PMID: 36031303 PMC: 10191258. DOI: 10.1016/B978-0-323-91532-8.00012-4.

Challenges in Decoding Sudden Unexpected Death in Epilepsy: The Intersection Between Heart and Brain in Epilepsy.

Asatryan B J Am Heart Assoc. 2021; 10(23):e023571.

PMID: 34816737 PMC: 9075400. DOI: 10.1161/JAHA.121.023571.

Confirmation of Cause of Death Via Comprehensive Autopsy and Whole Exome Molecular Sequencing in People With Epilepsy and Sudden Unexpected Death.

Chahal C, Tester D, Fayyaz A, Jaliparthy K, Khan N, Lu D J Am Heart Assoc. 2021; 10(23):e021170.

PMID: 34816733 PMC: 9075361. DOI: 10.1161/JAHA.121.021170.

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