Journal article
From unwitnessed fatality to witnessed rescue: Pharmacologic intervention in sudden unexpected death in epilepsy
Epilepsia (Copenhagen), Vol.57 Suppl 1(S1), pp.35-45
01/2016
DOI: 10.1111/epi.13236
PMCID: PMC4890608
PMID: 26749015
Abstract
The mechanisms of sudden unexpected death in epilepsy (SUDEP) have been difficult to define, as most cases occur unwitnessed, and physiologic recordings have been obtained in only a handful of cases. However, recent data obtained from human cases and experimental studies in animal models have brought us closer to identifying potential mechanisms. Theories of SUDEP should be able to explain how a seizure starting in the forebrain can sometimes lead to changes in brainstem cardiorespiratory control mechanisms. Herein we focus on three major themes of work on the causes of SUDEP. First, evidence is reviewed identifying postictal hypoventilation as a major contributor to the cause of death. Second, data are discussed that brainstem serotonin and adenosine pathways may be involved, as well as how they may contribute. Finally, parallels are drawn between SIDS and SUDEP, and we highlight similarities pointing to the possibility of shared pathophysiology involving combined failure of respiratory and cardiovascular control mechanisms. Knowledge about the causes of SUDEP may lead to potential pharmacologic approaches for prevention. We end by describing how translation of this work may result in future applications to clinical care.
Details
- Title: Subtitle
- From unwitnessed fatality to witnessed rescue: Pharmacologic intervention in sudden unexpected death in epilepsy
- Creators
- George B Richerson - Departments of Neurology and Molecular Physiology & Biophysics, University of Iowa & Veteran's Affairs Medical Center, Iowa City, Iowa, U.S.ADetlev Boison - Robert Stone Dow Neurobiology Laboratories, Legacy Research Institute Portland, Portland, Oregon, U.S.ACarl L Faingold - Departments of Pharmacology and Neurology and Division of Neurosurgery, Southern Illinois University School of Medicine, Springfield, Illinois, U.S.APhilippe Ryvlin - Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
- Resource Type
- Journal article
- Publication Details
- Epilepsia (Copenhagen), Vol.57 Suppl 1(S1), pp.35-45
- DOI
- 10.1111/epi.13236
- PMID
- 26749015
- PMCID
- PMC4890608
- NLM abbreviation
- Epilepsia
- ISSN
- 0013-9580
- eISSN
- 1528-1167
- Publisher
- United States
- Grant note
- R01 NS061844 / NINDS NIH HHS NS065957 / NINDS NIH HHS P20 NS076916 / NINDS NIH HHS NS061844 / NINDS NIH HHS R01 NS065957 / NINDS NIH HHS R01 HD052772 / NICHD NIH HHS P01 HD036379 / NICHD NIH HHS U54NS041069 / NINDS NIH HHS R01HD052772 / NICHD NIH HHS U54 NS041069 / NINDS NIH HHS P20NS076916 / NINDS NIH HHS P01HD36379 / NICHD NIH HHS U01 NS090414 / NINDS NIH HHS
- Language
- English
- Date published
- 01/2016
- Academic Unit
- Neurology; Molecular Physiology and Biophysics; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984020747202771
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