The Long and the Short of It: Seizures Induce Cardiac Remodeling and Arrhythmia

Sudden unexpected death in epilepsy (SUDEP) occurs when postmortem examination fails to determine the cause of death in a patient with epilepsy, and SUDEP the leading cause of death in patients with uncontrolled epilepsy.Therefore, the diagnosis is one of exclusion and does not have a clear pathophysiology.It accounts for approximately 15-20% of deaths associated with epilepsy.A number of different pathological mechanisms are suspected to contribute to SUDEP, including dysregulation in cardiac, respiratory, circulatory, hormonal, and metabolic function (1).Animal models and clinical data are increasingly identifying possible biomarkers that link epilepsy, cardiac arrhythmias, and SUDEP (2).Seizures appear to cause lethal cardiac arrhythmias through autonomic dysregulation, and cardiac arrhythmias can induce seizures because they can cause cerebral hypoxia (3, 4), and long-term, uncontrolled seizures may eventually lead to cellular and structural remodeling