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Methods for ECG Evaluation of Indicators of Cardiac Risk, and Susceptibility to Aconitine-induced Arrhythmias in Rats Following Status Epilepticus
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Patients with epilepsy who die suddenly have cardiac disease

B H Natelson1, R V Suarez, C F Terrence

  • 1Department of Neurosciences, New Jersey Medical School, Newark, USA.

Archives of Neurology
|June 17, 1998
PubMed
Abstract

Insights

Sudden unexpected death in epilepsy (SUDEP) may be linked to occult cardiac pathology. This study found significant heart abnormalities in epilepsy patients who died suddenly, suggesting a cardiac cause for SUDEP.

Area of Science:

  • Cardiology
  • Neurology
  • Pathology

Background:

  • Sudden unexpected death in epilepsy (SUDEP) affects approximately 1 in 1000 patients.
  • The cause of SUDEP remains largely unknown, with a lack of obvious medical explanation.

Purpose of the Study:

  • To investigate the presence of occult cardiac pathology in patients with epilepsy who experienced sudden, unexplained death.
  • To determine if cardiac abnormalities contribute to SUDEP.

Main Methods:

  • Pathologic evaluation of hearts from 7 epilepsy patients who died suddenly and 13 controls.
  • Hearts were examined for disease in the absence of known cardiac issues or adrenergic drug use.
  • Independent blinded review by two cardiac pathologists.

Main Results:

  • Cardiac pathology was identified in 5 of 7 epilepsy patient hearts, versus none in controls.
  • Irreversible pathology (fibrosis) was found in 4 hearts; reversible pathology (vacuolization) in 5.
  • Lesions were primarily located in the subendocardium.

Conclusions:

  • Findings support the hypothesis that cardiac pathologic conditions contribute to sudden, unexpected deaths in epilepsy patients.
  • Identified cardiac abnormalities may be the underlying cause of SUDEP.

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