Epileptic Heart

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2]

Overview

Chronic epileptic episodes and the subsequent catecholamine surges and hypoxia events may affect the heart and coronary vessels and result in the dysfunction of the heart, this condition has known as the epileptic heart. This concept first described by Dr. Richard L. Verrier and his colleagues in 2020.

Historical Perspective

  • The Absence of cardiac activity during epilepsy, first described by Dr. A.E.Russell, an English physician, in 1906.[1]
  • The epileptic heart was first discribed by Dr. Richard L. Verrier and his colleagues, in 2020.[2]

Classification

  • There is no established system for the classification of the epileptic heart.

Pathophysiology

  • The exact mechanisms involved in the epileptic heart is still should be elucidated. However, the algorithm below provides beneficial information on the development of heart disease in the context of epilepsy.[3]
 
 
 
 
 
 
 
 
Epilepsy
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Cardiac effects
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Repeated hypoxia and subsequent myocardial ischemia
 
 
 
 
 
 
 
 
 
 
 
Cathecholamines-induced cardiotoxicity
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Accelerated atherosclerosis
 
 
 
 
Myocardial stunning
 
 
 
 
Vacuolization of myocytes and fibrosis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Epileptic Heart

Instability in cardiac electrical system
T wave alternans
 
 
 
 
 
 
 


Epilepsy and Cardiac Arrhythmia

Cardiac arrhythmia have long been observed in patients with epilepsy. There are three different mechanisms that explain this association:[4]

Epilepsy and Structural Heart Disease

Three mechanisms have been suggested to explain the association between epilepsy and structural heart disease:[4]

References

  1. Russell, A.E. (1906). "CESSATION OF THE PULSE DURING THE ONSET OF EPILEPTIC FITS,". The Lancet. 168 (4325): 152–154. doi:10.1016/S0140-6736(01)30477-4. ISSN 0140-6736.
  2. Verrier, Richard L.; Pang, Trudy D.; Nearing, Bruce D.; Schachter, Steven C. (2020). "The Epileptic Heart: Concept and clinical evidence". Epilepsy & Behavior. 105: 106946. doi:10.1016/j.yebeh.2020.106946. ISSN 1525-5050.
  3. Verrier, Richard L.; Schachter, Steven C. (2018). "Is heart disease in chronic epilepsy a consequence of seizures or a fellow traveler?". Epilepsy & Behavior. 86: 211–213. doi:10.1016/j.yebeh.2018.06.027. ISSN 1525-5050.
  4. 4.0 4.1 Shmuely, S.; van der Lende, M.; Lamberts, R.J.; Sander, J.W.; Thijs, R.D. (2017). "The heart of epilepsy: Current views and future concepts". Seizure. 44: 176–183. doi:10.1016/j.seizure.2016.10.001. ISSN 1059-1311.