You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


ABOUT ARCHIVES
Advanced Search

Welcome   | My Account | E-mail Alerts | Access Rights | Sign In


  Vol. 55 No. 6, June 1998 TABLE OF CONTENTS
  Archives
  •  Online Features
  Observation
 This Article
 •Full text
 •PDF
 • Reply to article
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Citing articles on ISI (49)
 •Contact me when this article is cited
 Related Content
 •Similar articles in this journal
 Topic Collections
 •Epilepsy
 •Alert me on articles by topic

Patients With Epilepsy Who Die Suddenly Have Cardiac Disease

Benjamin H. Natelson, MD; Ronald V. Suarez, MD; Christopher F. Terrence, MD; Rosa Turizo, MD

Arch Neurol. 1998;55:857-860.

Background  Approximately 1 in 1000 patients with epilepsy dies suddenly and unexpectedly with no obvious medical cause. The purpose of this study was to determine if the hearts of such individuals harbor occult cardiac pathology.

Design  Following a comprehensive protocol, we performed careful pathologic evaluations of the hearts of 7 patients with epilepsy who died suddenly and 13 previously healthy people who died by hanging or a drug overdose. Hearts were studied only when there was no history or gross anatomical evidence of heart disease or the use of adrenergic drugs.

Methods  Multiple sections of each heart were evaluated independently by 2 cardiac pathologists who were blinded to patient group.

Results  Pathologic conditions were found in 5 hearts in the group with epilepsy and in none of the hearts in the comparison group. Four of the 7 hearts in the group with epilepsy had evidence of irreversible pathology in the form of perivascular and interstitial fibrosis. These 4 hearts plus a fifth had evidence of reversible pathology in the form of myocyte vacuolization. Lesions occurred predominantly in the subendocardium.

Conclusion  Our results support the hypothesis that patients with epilepsy who die suddenly and unexpectedly have cardiac pathologic conditions that may be responsible for their deaths.


From the Department of Neurosciences, New Jersey Medical School, Newark (Drs Natelson, Suarez, and Terrence); the Neurology Service, Veterans Affairs Medical Center, East Orange (Drs Natelson and Terrence); and Morris County Medical Examiner's Office, Morristown (Drs Suarez and Turizo), NJ. Dr Turizo participated in this work while on sabbatical from the Department of Pathology, University of Antioquia, Medellin, Colombia.



THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Stroke-Induced Sudden-Autonomic Death: Areas of Fatality Beyond the Insula
Hilz and Schwab
Stroke 2008;39:2421-2422.
FULL TEXT  

Postictal neurogenic stunned myocardium
Chin et al.
Neurology 2005;64:1977-1978.
ABSTRACT | FULL TEXT  

Cardiac troponin levels following monitored epileptic seizures
Woodruff et al.
Neurology 2003;60:1690-1692.
ABSTRACT | FULL TEXT  

Decrease of sympathetic cardiovascular modulation after temporal lobe epilepsy surgery
Hilz et al.
Brain 2002;125:985-995.
ABSTRACT | FULL TEXT  

Interictal cardiac autonomic dysfunction in temporal lobe epilepsy demonstrated by [123I]metaiodobenzylguanidine-SPECT
Druschky et al.
Brain 2001;124:2372-2382.
ABSTRACT | FULL TEXT  

Sudden withdrawal of carbamazepine increases cardiac sympathetic activity in sleep
Hennessy et al.
Neurology 2001;57:1650-1654.
ABSTRACT | FULL TEXT  

Sudden unexpected death in epilepsy: a series of witnessed deaths
Langan et al.
J. Neurol. Neurosurg. Psychiatry 2000;68:211-213.
ABSTRACT | FULL TEXT  

Current concepts in medicine: Sudden unexpected death in epilepsy
Lhatoo et al.
Postgrad. Med. J. 1999;75:706-709.
ABSTRACT | FULL TEXT  

Postictal heart rate oscillations in partial epilepsy
Al-Aweel et al.
Neurology 1999;53:1590-1590.
ABSTRACT | FULL TEXT  

Sudden unexpected death in epilepsy (SUDEP): a clinical perspective and a search for risk factors
Kloster and Engelskjon
J. Neurol. Neurosurg. Psychiatry 1999;67:439-444.
ABSTRACT | FULL TEXT  

Patients With Epilepsy Who Die Suddenly Do Not Always Have Cardiac Disease
Langan and Sander
Arch Neurol 1999;56:249-249.
FULL TEXT  





HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 1998 American Medical Association. All Rights Reserved.