title: Sudden unexpected death in epilepsy or voodoo heart: analysis of heart/brain connections.
abstract: Sudden unexpected death in epilepsy (SUDEP) affects up to 5000 patients a year in the United States alone. The exact pathophysiologic processes of are unknown. Profound autonomic dysregulation driving cardiac and respiratory dysfunction is likely. Available evidence from monitored deaths suggests that fatal tachyarrhythmias are not primarily responsible although near deaths due to ventricular arrhythmias have been reported. Genetic "neuro-cardiac" channelopathies affecting brain function, central respiratory processes, and cardiac rhythm have been hypothesized. These, as well as serotonergic mechanisms affecting brainstem homeostasis of cardiac and respiratory function are important areas of current and future SUDEP research.
authors.affiliation: Epilepsy Center, Department of Neurology, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA, Narges.Moghimi@uhhospitals.org.
authors.forename: Narges
authors.initials: N
authors.lastname: Moghimi
authors.forename: Samden D
authors.initials: SD
authors.lastname: Lhatoo
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects; D001145:Arrhythmias, Cardiac / Q000401:mortality / Q000503:physiopathology*; D001341:Autonomic Nervous System / Q000503:physiopathology*; D053840:Brugada Syndrome; D002220:Carbamazepine / Q000009:adverse effects; D000075224:Cardiac Conduction System Disease; D002540:Cerebral Cortex / Q000503:physiopathology*; D053447:Channelopathies / Q000401:mortality / Q000503:physiopathology*; D003645:Death, Sudden / Q000453:epidemiology / Q000209:etiology*; D004827:Epilepsy / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D005260:Female; D006329:Heart Conduction System / Q000002:abnormalities* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine