ABSTRACT
Sudden and unexpected death in epilepsy (SUDEP) is the most common type of death among patients with epilepsy. Here, we address the importance of the experimental models in search of the mechanisms underlying SUDEP. Most studies have investigated the cardiovascular responses in animal models of epilepsy. However, there are few proposed SUDEP models in literature. Hypoventilation, apnea, respiratory distress, pulmonary hypertension, autonomic dysregulation and arrhythmia are common findings in epilepsy models. Impairments on adenosinergic and serotonergic systems, brainstem spreading depolarization, seizure-activation of neural substrates related to cardiorespiratory control, altered autonomic control, and mutations on sodium and potassium channels are hypothesis suggested. Overall, current research highlights the evident multifactorial nature of SUDEP, which involves acute and chronic aspects ranging from systemic to molecular alterations. Thus, we are convinced that elucidation and prevention of SUDEP can be achieved only through the interaction between basic and clinical science.
Acknowledgements
The authors would like to thank Damien Depannemaecker for English language review.
Financial & competing interests disclosure
The authors were supported by CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico), FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo), FAPEMIG (Fundação de Amparo à Pesquisa do Estado de Minas Gerais), CAPES (Coordenação de Aperfeiçoamento de pessoal de nível Superior) and FAPEG (Fundação de Amparo à Pesquisa do Estado de Goiás). AP Pansani was supported by CNPq and FAPEG. FA Scorza was supported by CNPq, CAPES and FAPESP. CA Scorza was supported by CNPq and FAPESP. ACG De Almeida was supported by CNPq and FAPEMIG. EA Cavalheiro was supported by CNPq and FAPESP.