Journal article
Postictal serotonin levels are associated with peri-ictal apnea
Neurology, Vol.93(15), pp.10-e1494
09/04/2019
DOI: 10.1212/WNL.0000000000008244
PMID: 31484709
Abstract
Objective: To determine the relationship between serum serotonin (5-HT) levels, ictal central apnea (ICA), and postconvulsive central apnea (PCCA) in epileptic seizures.
Methods: We prospectively evaluated video EEG, plethysmography, capillary oxygen saturation (SpO2), and ECG for 49 patients (49 seizures) enrolled in a multicenter study of sudden unexpected death in epilepsy (SUDEP). Postictal and interictal venous blood samples were collected after a clinical seizure for measurement of serum 5-HT levels. Seizures were classified according to the International League Against Epilepsy 2017 seizure classification. We analyzed seizures with and without ICA (n = 49) and generalized convulsive seizures (GCS) with and without PCCA (n = 27).
Results: Postictal serum 5-HT levels were increased over interictal levels for seizures without ICA (p = 0.01), compared to seizures with ICA (p = 0.21). In patients with GCS without PCCA, serum 5-HT levels were increased postictally compared to interictal levels (p < 0.001), but not in patients with seizures with PCCA (p = 0.22). Postictal minus interictal 5-HT levels also differed between the 2 groups with and without PCCA (p = 0.03). Increased heart rate was accompanied by increased serum 5-HT levels (postictal minus interictal) after seizures without PCCA (p = 0.03) compared to those with PCCA (p = 0.42).
Conclusions: The data suggest that significant seizure-related increases in serum 5-HT levels are associated with a lower incidence of seizure-related breathing dysfunction, and may reflect physiologic changes that confer a protective effect against deleterious phenomena leading to SUDEP. These results need to be confirmed with a larger sample size study.
Details
- Title: Subtitle
- Postictal serotonin levels are associated with peri-ictal apnea
- Creators
- Arun MurugesanM.R. Sandhya RaniLaura VilellaNuria LacueyJohnson P HampsonCarl L FaingoldDaniel FriedmanOrrin DevinskyRup K SainjuStephan SchueleBeate DiehlMaromi NeiRonald M HarperLisa M BatemanGeorge RichersonSamden D Lhatoo
- Resource Type
- Journal article
- Publication Details
- Neurology, Vol.93(15), pp.10-e1494
- DOI
- 10.1212/WNL.0000000000008244
- PMID
- 31484709
- NLM abbreviation
- Neurology
- ISSN
- 0028-3878
- eISSN
- 1526-632X
- Language
- English
- Date published
- 09/04/2019
- Academic Unit
- Neurology; Molecular Physiology and Biophysics; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984070532902771
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