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Seizure-related autonomic changes in children

Brian D Moseley1

  • 1Department of Neurology, University of Cincinnati, Cincinnati, Ohio, U.S.A.

Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society
|February 4, 2015
PubMed

Insights

Sudden unexpected death in epilepsy (SUDEP) is a significant risk for children, often linked to seizure-induced autonomic dysfunction. Understanding these age-related autonomic changes is crucial for preventing SUDEP in pediatric epilepsy patients.

Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Autonomic Neuroscience

Background:

  • Sudden unexpected death in epilepsy (SUDEP) is a critical concern in both pediatric and adult populations.
  • While less frequent in children than adults, SUDEP remains a significant epilepsy-related cause of mortality in this age group.
  • The underlying pathophysiology is thought to involve seizure-related autonomic nervous system dysfunction.

Purpose of the Study:

  • To review the autonomic changes associated with seizures during the pediatric period.
  • To explore how these age-related autonomic effects relate to the risk of SUDEP.
  • To highlight the urgent need for this knowledge, particularly in high-risk pediatric epilepsy populations like Dravet syndrome.

Main Methods:

  • Review of existing literature on seizure-related autonomic changes in children.
  • Analysis of documented autonomic alterations during pediatric seizures.
  • Correlation of autonomic dysfunction with SUDEP risk factors.

Main Results:

  • Pediatric seizures can induce profound autonomic alterations, including nausea, emesis, hypersalivation, hypoxemia, and apnea.
  • Significant cardiac effects such as tachycardia, bradycardia, and altered repolarization have been observed.
  • Reduced heart rate variability and postictal generalized EEG suppression are also noted autonomic consequences.

Conclusions:

  • Seizure-related autonomic dysfunction is a key factor in pediatric SUDEP, mirroring adult pathophysiology.
  • Understanding the specific age-related autonomic effects of seizures is vital for elucidating SUDEP mechanisms.
  • Further research is essential to develop targeted strategies for SUDEP prevention in children, especially those with severe epilepsy syndromes.
Abstract

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