Abstract
Profound cardiovascular and/or respiratory dysfunction is part of the terminal cascade in sudden unexpected death in epilepsy (SUDEP). Central control of ventilation is mediated by brainstem rhythm generators, which are influenced by a variety of inputs, many of which use the modulatory neurotransmitter serotonin to mediate important inputs for breathing. The aim of this study was to investigate epileptic seizure–induced changes in serum serotonin levels and whether there are potential implications for SUDEP. Forty-one epileptic patients were pooled into 2 groups based on seizure type as (1) generalized tonic–clonic seizures (GTCS) of genetic generalized epilepsy and focal to bilateral tonic–clonic seizures (FBTCS; n = 19) and (2) focal seizures (n = 26) based on clinical signs using surface video-electroencephalography. Postictal serotonin levels were statistically significantly higher after GTCS and FBTCS compared to interictal levels (P =.002) but not focal seizures (P =.941). The change in serotonin (postictal-interictal) was inversely associated with a shorter duration of tonic phase of generalized seizures. The interictal serotonin level was inversely associated with a shorter period of postictal generalized electroencephalographic suppression. These data suggest that peripheral serum serotonin levels may play a role in seizure features and earlier postseizure recovery; these findings merit further study.
Original language | English (US) |
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Pages (from-to) | e91-e97 |
Journal | Epilepsia |
Volume | 59 |
Issue number | 6 |
DOIs | |
State | Published - Jun 2018 |
Funding
S.D.L. has been funded by the Center for SUDEP Research (National Institutes of Health [NIH]/National Institute of Neurological Disorders and Stroke [NINDS] U01-NS090405 and NIH/NINDS U01-NS090407). B.Z., M.R.S.R., S.S., R.K.S., M.N., R.M.H., B.D., and L.M.B. have been funded by NIH/NINDS U01-NS090407. O.D. has been funded by the Center for SUDEP Research (NIH/ NINDS UO1-NS090415 and NIH/NINDS U01-NS090407). G.R. has been funded by the Center for SUDEP Research (NIH/NINDS UO1-NS090414). S.S. is on the speaker’s bureau for Sunovion and Eisai. A.M., J.H., N.L., C.L.F., and D.F. have no conflict of interest to disclose. We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.
Keywords
- focal
- generalized
- postictal EEG suppression
- sudden unexpected death in epilepsy
- tonic
ASJC Scopus subject areas
- Neurology
- Clinical Neurology