K+ channel; P-glycoprotein; catecholamines; epilepsy; mechanism; mortality; renin-angiotensin system; sudden unexpected death in epilepsy; Neurology; Neurology (clinical)
Abstract :
[en] Sudden unexpected death in epilepsy (SUDEP) is defined as a sudden, unexpected, non-traumatic, non-drowning death in a person with epilepsy. SUDEP is generally considered to result from seizure-related cardiac dysfunction, respiratory depression, autonomic nervous dysfunction, or brain dysfunction. Frequency of generalized tonic clonic seizures (GTCS), prone posture, and refractory epilepsy are considered risk factors. SUDEP has also been associated with inherited cardiac ion channel disease and severe obstructive sleep apnea. Most previous studies of SUDEP mechanisms have focused on cardiac and respiratory dysfunction and imbalance of the neural regulatory system. Cardiac-related mechanisms include reduction in heart rate variability and prolongation of QT interval, which can lead to arrhythmias. Laryngospasm and amygdala activation may cause obstructive and central apnea, respectively. Neural mechanisms include impairment of 5-HT and adenosine neuromodulation. The research to date regarding molecular mechanisms of SUDEP is relatively limited. Most studies have focused on p-glycoprotein, catecholamines, potassium channels, and the renin-angiotensin system, all of which affect cardiac and respiratory function.
Disciplines :
Biochemistry, biophysics & molecular biology
Author, co-author :
Sun, Xinyi ; Université de Liège - ULiège > Département de pharmacie > Chimie pharmaceutique ; School of Basic Medical Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
Lv, Yehui; School of Basic Medical Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China ; Institute of Wound Prevention and Treatment, Shanghai University of Medicine and Health Sciences, Shanghai, China
Lin, Jian; Institute of Wound Prevention and Treatment, Shanghai University of Medicine and Health Sciences, Shanghai, China ; Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
Language :
English
Title :
The mechanism of sudden unexpected death in epilepsy: A mini review.
This work was funded by the Shanghai Sailing Plan (21YF1418800), the National Innovative Foundation Project for Students (202210262058) and the Shanghai Key Laboratory of Forensic Medicine, Academy of Forensic Science (KF1902).
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