Epilepsy is a chronic neurological disorder, characterized by predisposition to recurrent seizures. Epilepsy patients show an increased mortality rate, and cardiovascular disease is a significant cause of death. The interrelationship between epilepsy and hearth is complex and many physiopathological aspects still remain unclear. Epilepsy may induce both acute and chronic cardiac changes. The Central Autonomic Network (CAN) includes cortical, subcortical, hypothalamic, and subthalamic regions which control the activity of preganglionic sympathetic and parasympathetic neurons; activation or deactivation of CAN may be responsible for cardiac changes related to seizures. Acute cardiac effects of seizures include ictal tachycardia, ictal bradycardia syndrome (including bradycardia and asystole), postictal asystole, postictal atrial, and ventricular fibrillation; periictal QT changes, cardiac ischemia, and acute stress cardiomyopathy are also described. Chronic cardiac changes include reduced interictal heart rate variability and QT interval modifications. Both acute and chronic factors may be involved in the pathogenesis of SUDEP. Many drugs, i.e., Phenitoin, Carbamazepine, Lamotrigine, Lacosamide, have been associated with cardiac side effects. Levetiracetam, Valproic Acid, and other AEDs are relatively free of any untoward cardiac effect.
Epilepsy and Cardiovascular Function: Seizures and Antiepileptic Drugs Effects
Toscano G.;Terzaghi M.
2020-01-01
Abstract
Epilepsy is a chronic neurological disorder, characterized by predisposition to recurrent seizures. Epilepsy patients show an increased mortality rate, and cardiovascular disease is a significant cause of death. The interrelationship between epilepsy and hearth is complex and many physiopathological aspects still remain unclear. Epilepsy may induce both acute and chronic cardiac changes. The Central Autonomic Network (CAN) includes cortical, subcortical, hypothalamic, and subthalamic regions which control the activity of preganglionic sympathetic and parasympathetic neurons; activation or deactivation of CAN may be responsible for cardiac changes related to seizures. Acute cardiac effects of seizures include ictal tachycardia, ictal bradycardia syndrome (including bradycardia and asystole), postictal asystole, postictal atrial, and ventricular fibrillation; periictal QT changes, cardiac ischemia, and acute stress cardiomyopathy are also described. Chronic cardiac changes include reduced interictal heart rate variability and QT interval modifications. Both acute and chronic factors may be involved in the pathogenesis of SUDEP. Many drugs, i.e., Phenitoin, Carbamazepine, Lamotrigine, Lacosamide, have been associated with cardiac side effects. Levetiracetam, Valproic Acid, and other AEDs are relatively free of any untoward cardiac effect.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
