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Updated: Jan 20, 2026

Experimental Model of Ligature-Induced Peri-Implantitis in Mice
Published on: May 17, 2024
Postictal serotonin levels are associated with peri-ictal apnea
Arun Murugesan1, M R Sandhya Rani2, Laura Vilella1
1From the Department of Neurology (A.M.), Case Western Reserve University; Department of Neurology (M.R.S.R., L.V., N.L., J.P.H., S.D.L.), McGovern Medical School, University of Texas Health Science Center at Houston; Department of Pharmacology and Neurology (C.L.F.), Southern Illinois University School of Medicine, Springfield; Department of Neurology (D.F., O.D.), New York University School of Medicine, New York; Department of Neurology (R.K.S., G.R.), University of Iowa Carver College of Medicine, Iowa City; Department of Neurology (S.S.), Northwestern University Feinberg School of Medicine, Chicago, IL; Institute of Neurology (B.D.), University College London, UK; Department of Neurology (M.N.), Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA; Department of Neurobiology (R.M.H.), David Geffen School of Medicine at UCLA, Los Angeles, CA; Department of Neurology (L.M.B.), Columbia University Medical Center, New York, NY; and Center for SUDEP Research (M.R.S.R., L.V., N.L., D.F., O.D., R.K.S., S.S., B.D., M.N., R.M.H., L.M.B., G.R., S.D.L.), National Institute for Neurological Disorders and Stroke, Bethesda, MD.
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.
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