Autonomic manifestations of epilepsy: emerging pathways to sudden death?
Details
Serval ID
serval:BIB_502D3614A2CC
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Autonomic manifestations of epilepsy: emerging pathways to sudden death?
Journal
Nature reviews. Neurology
ISSN
1759-4766 (Electronic)
ISSN-L
1759-4758
Publication state
Published
Issued date
12/2021
Peer-reviewed
Oui
Volume
17
Number
12
Pages
774-788
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Publication Status: ppublish
Publication Status: ppublish
Abstract
Epileptic networks are intimately connected with the autonomic nervous system, as exemplified by a plethora of ictal (during a seizure) autonomic manifestations, including epigastric sensations, palpitations, goosebumps and syncope (fainting). Ictal autonomic changes might serve as diagnostic clues, provide targets for seizure detection and help us to understand the mechanisms that underlie sudden unexpected death in epilepsy (SUDEP). Autonomic alterations are generally more prominent in focal seizures originating from the temporal lobe, demonstrating the importance of limbic structures to the autonomic nervous system, and are particularly pronounced in focal-to-bilateral and generalized tonic-clonic seizures. The presence, type and severity of autonomic features are determined by the seizure onset zone, propagation pathways, lateralization and timing of the seizures, and the presence of interictal autonomic dysfunction. Evidence is mounting that not all autonomic manifestations are linked to SUDEP. In addition, experimental and clinical data emphasize the heterogeneity of SUDEP and its infrequent overlap with sudden cardiac death. Here, we review the spectrum and diagnostic value of the mostly benign and self-limiting autonomic manifestations of epilepsy. In particular, we focus on presentations that are likely to contribute to SUDEP and discuss how wearable devices might help to prevent SUDEP.
Keywords
Anticonvulsants/therapeutic use, Autonomic Nervous System Diseases/etiology, Autonomic Nervous System Diseases/physiopathology, Death, Sudden/prevention & control, Epilepsy/complications, Epilepsy/physiopathology, Humans, Sudden Unexpected Death in Epilepsy, Wearable Electronic Devices
Pubmed
Web of science
Create date
09/11/2021 11:01
Last modification date
10/02/2024 7:16