scholarly journals Is there something special about cardiovascular abnormalities and sudden unexpected death in epilepsy among patients with chronic renal insufficiency in regular hemodialysis program?

2009 ◽  
Vol 67 (2a) ◽  
pp. 209-213 ◽  
Author(s):  
Rui A. Gomes ◽  
Silvana Kesrouani ◽  
Jenner Cruz ◽  
Alexandre L. Silva ◽  
Tânia M.G. Henriques ◽  
...  
Keyword(s):  
Renal Insufficiency ◽  
Chronic Renal Insufficiency ◽  
Sudden Unexpected Death ◽  
Unexpected Death ◽  
Cardiovascular Abnormalities ◽  
History Of ◽  
Clonic Seizures ◽  
Convulsive Seizures ◽  
The Many ◽  
Regular Hemodialysis

Of the many risk factors suggested for sudden unexpected death in epilepsy (SUDEP), higher frequency of seizures is a very consistent issue. Following this reasoning, it has been established that hemodialysis-associated seizure is a complication of dialysis procedure. Based on these facts, this study investigated a possible association between cardiovascular abnormalities and SUDEP among patients with chronic renal insufficiency in regular hemodialysis program. For that, a retrospective medical history of 209 patients was reviewed to investigate the occurrence of convulsive seizures and EKG abnormalities during dialytic program. Three patients presented generalized tonic-clonic seizures, one had partial seizure with secondary generalization, and one presented unclassified seizure. Any EKG abnormalities and SUDEP event were found in all patients evaluated. In conclusion, the present findings demonstrated uncommon the occurrence of seizures and also SUDEP. Probably, the main justification to not allow us to demonstrated a direct relation between SUDEP and cardiovascular diseases in hemodialysis are the reduced number of cases examined.

scholarly journals Reducing Sudden Unexpected Death in Epilepsy: Considering Risk Factors, Pathophysiology and Strategies

2021 ◽  
Vol 23 (11) ◽  
Author(s):  
Nathan A. Shlobin ◽  
Josemir W. Sander
Keyword(s):  
Risk Factors ◽  
Significant Proportion ◽  
Premature Mortality ◽  
Sudden Unexpected Death ◽  
Unexpected Death ◽  
Cardiorespiratory Function ◽  
Younger Age ◽  
History Of ◽  
Symptomatic Epilepsy ◽  
Convulsive Seizures

Abstract Purpose of Review Sudden Unexpected Death in Epilepsy (SUDEP) is the commonest cause of epilepsy-related premature mortality in people with chronic epilepsy. It is the most devastating epilepsy outcome. We describe and discuss risk factors and possible pathophysiological mechanisms to elucidate possible preventative strategies to avert SUDEP. Recent Findings Sudden death accounts for a significant proportion of premature mortality in people with epilepsy compared to the general population. Unmodifiable risk factors include a history of neurologic insult, younger age of seizure-onset, longer epilepsy duration, a history of convulsions, symptomatic epilepsy, intellectual disability, and non-ambulatory status. Modifiable risk factors include the presence of convulsive seizures, increased seizure frequency, timely and appropriate use of antiseizure medications, polytherapy, alcoholism, and supervision while sleeping. Pathophysiology is unclear, but several possible mechanisms such as direct alteration of cardiorespiratory function, pulmonary impairment, electrocerebral shutdown, adenosine dysfunction, and genetic susceptibility suggested. Summary Methods to prevent SUDEP include increasing awareness of SUDEP, augmenting knowledge of unmodifiable risk factors, obtaining full seizure remission, addressing lifestyle factors such as supervision and prone positioning, and enacting protocols to increase the detection of and intervention for SUDEP. Further studies are required to characterize precisely and comprehensively SUDEP risk factors and pathophysiological drivers and develop evidence-based algorithms to minimize SUDEP in people with epilepsy.

scholarly journals Seizure occurrence in patients with chronic renal insufficiency in regular hemodialysis program

2005 ◽  
Vol 63 (3b) ◽  
pp. 757-760 ◽  
Author(s):  
Fulvio Alexandre Scorza ◽  
Marly de Albuquerque ◽  
Ricardo Mario Arida ◽  
Roberta Monterazzo Cysneiros ◽  
Tânia Maria Guedes Henriques ◽  
...  
Keyword(s):  
End Stage Renal Disease ◽  
Convulsive Status Epilepticus ◽  
Dialysis Therapy ◽  
Paulo State ◽  
History Of ◽  
Clonic Seizures ◽  
Convulsive Seizures ◽  
Stage Renal Disease ◽  
End Stage ◽  
Regular Hemodialysis

Hemodialysis-associated seizure is a complication of hemodialysis. This report describes the occurrence of seizures in patients with end stage renal disease on dialysis therapy at the Nephrology Institute of Mogi das Cruzes, São Paulo State, Brazil. A retrospective medical history of 189 patients was reviewed to investigate the occurrence of convulsive seizures during dialytic program. Seven patients with history of seizures were selected but five of them were included in our study. Three patients presented generalized tonic-clonic seizures, one had partial seizure with secondary generalization, and one presented unclassified seizure. Three patients presented seizure just during the dialysis (unique seizure) and one of them presented convulsive status epilepticus. The two other patients had already presented seizures prior the beginning of dialysis. We conclude that seizures in renal failure could be considered as occasional events that do not usually become chronic.

scholarly journals Omega-3 intake in people with epilepsy under regular hemodialysis program: here to stay

2013 ◽  
Vol 71 (7) ◽  
pp. 474-477
Author(s):  
Carla Alessandra Scorza ◽  
Ricardo Mario Arida ◽  
Roberta Monterazzo Cysneiros ◽  
Esper Abrão Cavalheiro ◽  
Fulvio Alexandre Scorza
Keyword(s):  
Risk Factors ◽  
Fatty Acids ◽  
Sudden Cardiac Death ◽  
Renal Insufficiency ◽  
Cardiac Death ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Unexpected Death ◽  
The Many ◽  
Regular Hemodialysis

Among the many risk factors suggested for sudden unexpected death in epilepsy (SUDEP), higher frequency of seizures is a very consistent issue. Furthermore, it has been established that hemodialysis-associated seizure is a complication of the dialysis procedure. Thus, since a possible relation between cardiovascular abnormalities and SUDEP among patients with chronic renal insufficiency in regular hemodialysis program should not be neglected, we propose in this paper that omega-3 fatty acids offer opportunities for prevention of sudden cardiac death or improved treatment in people with epilepsy under the regular hemodialysis program.

Sudden, Unexpected Death Associated with Meningioangiomatosis: Case Report

2005 ◽  
Vol 8 (2) ◽  
pp. 240-244 ◽  
Author(s):  
Chris Wixom ◽  
Amy E. Chadwick ◽  
Henry F. Krous
Keyword(s):  
Case Report ◽  
Family History ◽  
Postmortem Examination ◽  
Sudden Unexpected Death ◽  
Healthy Male ◽  
Orbital Frontal Cortex ◽  
Unexpected Death ◽  
Microscopic Features ◽  
History Of ◽  
The Right

We report a case of sudden, unexpected death associated with meningioangiomatosis in a 13-year-old, previously healthy male without a history of seizures, neurologic deficits, or clinical stigmata of neurofibromatosis. There was no family history of neurofibromatosis. The postmortem examination showed a 5-cm mass involving the right posterior frontal and orbital frontal cortex that had microscopic features diagnostic of meningioangiomatosis. Because no other cause of death was found, we postulate that he likely died as a result of a seizure secondary to meningioangiomatosis.

Sudden Unexpected Death in Neonates: A Clinico-pathological Study

2018 ◽  
Vol 21 (6) ◽  
pp. 528-536 ◽  
Author(s):  
Jeanette A Reyes ◽  
Gino R Somers ◽  
David A Chiasson
Keyword(s):  
Physiological Stress ◽  
Growth Parameters ◽  
Wide Spectrum ◽  
Vital Signs ◽  
Clinical History ◽  
Sudden Unexpected Death ◽  
Unexpected Death ◽  
Inborn Errors ◽  
Ancillary Test ◽  
History Of

Clinico-pathological studies that focus on sudden unexpected death (SUD) in the neonatal period are rare. The objective of this study was to elucidate the frequency and pathological spectrum of anatomical causes of death (CODs), found in the setting of sudden unexpected death in neonates (SUD-N), and to correlate the COD with premortem circumstantial information. We conducted a detailed review of all autopsy reports on SUD-N cases at our institution from 1997 to 2015. Analyzed clinical data included obstetrical history, postpartum/neonatal medical course, and circumstances surrounding death. Evaluated autopsy data included growth parameters, pathological findings, ancillary test results, and COD. Data from decedents in which a COD was established (COD-E) were statistically compared with that from decedents in which the COD was undetermined (COD-U). Of 104 neonates (M: 49; F: 55) who fulfilled our inclusion criteria, a COD was established at autopsy in 46 cases (44%). Infections, congenital abnormalities, and inborn errors of metabolism were the most common CODs. Single variables statistically more likely to be found in COD-E neonates were clinical history of prodromal illness, witnessed loss of vital signs, and evidence of physiological stress in the thymus or the liver. A prodrome was statistically more common in the COD-E group, but the absence of a prodrome does not reliably exclude COD-E cases, since over 50% of these patients were asymptomatic prior to their demise. In COD-U neonates, the statistically significant factors were death during sleep, death during sleep while “bed”-sharing, “heavy” lungs, and petechial hemorrhages on the epicardium or pleura. Given the frequency and wide spectrum of underlying pathologies in COD-E neonates, referral of SUD-N cases to pathologists with specialized pediatric autopsy expertise is recommended.

scholarly journals Natural History of Renal Function in Childhood Chronic Renal Insufficiency (CRI)

1999 ◽  
Vol 45 (4, Part 2 of 2) ◽  
pp. 328A-328A
Author(s):  
G L Ardissino ◽  
V Dacco ◽  
S Testa ◽  
A Claris Appiani ◽  
F Sereni
Keyword(s):  
Renal Function ◽  
Natural History ◽  
Renal Insufficiency ◽  
Chronic Renal Insufficiency ◽  
History Of

scholarly journals Postictal brainstem hypoperfusion and risk factors for sudden unexpected death in epilepsy

Neurology ◽  
2020 ◽  
Vol 95 (12) ◽  
pp. e1694-e1705
Author(s):  
Jonathan Liu ◽  
Joseph S. Peedicail ◽  
Ismael Gaxiola-Valdez ◽  
Emmy Li ◽  
Victoria Mosher ◽  
...  
Keyword(s):  
Arterial Spin Labeling ◽  
Spin Labeling ◽  
Regions Of Interest ◽  
Sudden Unexpected Death ◽  
Seizure Type ◽  
Unexpected Death ◽  
Increased Risk ◽  
Impaired Awareness ◽  
Clonic Seizures ◽  
Respiratory Centers

ObjectiveSince the strongest risk factor for sudden unexpected death in epilepsy (SUDEP) is frequent bilateral tonic-clonic seizures (BTCS), our aim was to determine whether postictal hypoperfusion in brainstem respiratory centers (BRCs) is more common following tonic-clonic seizures.MethodsWe studied 21 patients with focal epilepsies who underwent perfusion imaging with arterial spin labeling MRI. Subtraction maps of cerebral blood flow were obtained from the postictal and baseline scans. We identified 6 regions of interest in the brainstem that contain key BRCs. Patients were considered to have postictal BRC hypoperfusion if any of the 6 regions of interest were significantly hypoperfused.ResultsAll 6 patients who experienced BTCS during the study had significant clusters of postictal hypoperfusion in BRCs compared to 7 who had focal impaired awareness seizures (7/15). The association between seizure type studied and the presence of BRC hypoperfusion was significant. Duration of epilepsy and frequency of BTCS were not associated with postictal brainstem hypoperfusion despite also being associated with risk for SUDEP.ConclusionPostictal hypoperfusion in brainstem respiratory centers occurs more often following BTCS than other seizure types, providing a possible explanation for the increased risk of SUDEP in patients who regularly experience BTCS.

scholarly journals Sudden unexpected death in children with epilepsy: The many faces of fungal pathogenicity

2012 ◽  
Vol 79 (2) ◽  
pp. 127-128 ◽  
Author(s):  
Monica L. Andersen ◽  
Sergio Tufik ◽  
Arnaldo L. Colombo ◽  
Esper A. Cavalheiro ◽  
Roberta M. Cysneiros ◽  
...  
Keyword(s):  
Sudden Unexpected Death ◽  
Unexpected Death ◽  
Fungal Pathogenicity ◽  
The Many

scholarly journals Sudden Death and Epilepsy

2005 ◽  
Vol 5 (6) ◽  
pp. 223-224 ◽  
Author(s):  
Elinor Ben-Menachem
Keyword(s):  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Geographic Location ◽  
Case Control ◽  
Related Phenomenon ◽  
Unexpected Death ◽  
Conditional Logistic Regression Analysis ◽  
History Of ◽  
Clonic Seizures ◽  
Control Study

Case–control Study of SUDEP Langan Y, Nashef L, Sander JW Neurology 2005;64:1131–1133 Purpose To examine the influence of various factors on the risk of sudden unexpected death in epilepsy (SUDEP). Methods The authors investigated 154 cases in which a postmortem examination was performed. Each case had four controls with epilepsy from the community, matched for age and geographic location. Backward stepwise conditional logistic regression analysis was performed, and odds ratios for risk and protection were determined. Results The risk of SUDEP was increased with a history of generalized tonic–clonic seizures in the previous 3 months (odds ratio [OR]: 13.8; 95% CI: 6.6 to 29.1). The presence of supervision at night was found to be protective (OR: 0.4; 95% CI: 0.2 to 0.8) when a supervising individual shared the same bedroom or when special precautions such as a listening device were used (OR: 0.1; 95% CI: 0.0 to 0.3). Conclusions This work lends support to the view that SUDEP is a seizure-related phenomenon and that control of tonic–clonic seizures is important in its prevention. Nocturnal supervision seems to protect against SUDEP.

scholarly journals Practice guideline summary: Sudden unexpected death in epilepsy incidence rates and risk factors

Neurology ◽  
2017 ◽  
Vol 88 (17) ◽  
pp. 1674-1680 ◽  
Author(s):  
Cynthia Harden ◽  
Torbjörn Tomson ◽  
David Gloss ◽  
Jeffrey Buchhalter ◽  
J. Helen Cross ◽  
...  
Keyword(s):  
Risk Factors ◽  
Evaluation Process ◽  
Incidence Rates ◽  
Sudden Unexpected Death ◽  
Seizure Freedom ◽  
Unexpected Death ◽  
New Approach ◽  
Assessment Development ◽  
Clonic Seizures ◽  
Patients With Epilepsy

Objective:To determine the incidence rates of sudden unexpected death in epilepsy (SUDEP) in different epilepsy populations and address the question of whether risk factors for SUDEP have been identified.Methods:Systematic review of evidence; modified Grading Recommendations Assessment, Development, and Evaluation process for developing conclusions; recommendations developed by consensus.Results:Findings for incidence rates based on 12 Class I studies include the following: SUDEP risk in children with epilepsy (aged 0–17 years) is 0.22/1,000 patient-years (95% confidence interval [CI] 0.16–0.31) (moderate confidence in evidence). SUDEP risk increases in adults to 1.2/1,000 patient-years (95% CI 0.64–2.32) (low confidence in evidence). The major risk factor for SUDEP is the occurrence of generalized tonic-clonic seizures (GTCS); the SUDEP risk increases in association with increasing frequency of GTCS occurrence (high confidence in evidence).Recommendations:Level B: Clinicians caring for young children with epilepsy should inform parents/guardians that in 1 year, SUDEP typically affects 1 in 4,500 children; therefore, 4,499 of 4,500 children will not be affected. Clinicians should inform adult patients with epilepsy that SUDEP typically affects 1 in 1,000 adults with epilepsy per year; therefore, annually 999 of 1,000 adults will not be affected. For persons with epilepsy who continue to experience GTCS, clinicians should continue to actively manage epilepsy therapies to reduce seizures and SUDEP risk while incorporating patient preferences and weighing the risks and benefits of any new approach. Clinicians should inform persons with epilepsy that seizure freedom, particularly freedom from GTCS, is strongly associated with decreased SUDEP risk.

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