Cerebroautonomic and Myographic Changes Accompanying Induced Seizures

Mosier, Jack M.; White, Philip T.; Grant, Phyllis; Fisher, John; Taylor, Richard A.

doi:10.1212/wnl.7.3.204

Cited by 16 publications

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“…It was, therefore, concluded that her severe, acute hypertension was caused directly by the convulsions themselves. Transient hypertension occurring only for the duration of a grand mal convulsion has been previously described (Mosier et al, 1957). However, in the present patient, the hypertension was sustained and persisted for many hours after the muscular overactivity associated with her convulsions had subsided.…”

Section: Discussionsupporting

confidence: 48%

“…Although the potential dangers of rapidly lowering systemic hypertension due to a neurogenic cause were fully appreciated, restoration of this patient's BP to normal levels proved entirely beneficial. The mechanism of the hypertension in this situation is unclear, but since this patient showed some clinical features of autonomic overactivity and in view of the fact that autonomic abnormalities in association with convulsions have been previously described (Van Buren, 1958;Mosier et al, 1957) the authors suggest that a paroxysmal autonomic nervous system disturbance was the most likely explanation. Although the hypertension which follows convulsions is usually mild, this case illustrates that it may be severe, prolonged and require urgent treatment.…”

Section: Discussionmentioning

confidence: 72%

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Transient severe hypertension following alcohol withdrawal convulsions

Kennedy

Moxham

1980

Postgraduate Medical Journal

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Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 72%

Transient severe hypertension following alcohol withdrawal convulsions

Kennedy

Moxham

1980

Postgraduate Medical Journal

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“…The incidence of sudden cardiac death due to ischaemic heart disease is increased in people with epilepsy 19. Examples of seizure related changes in the heart have been given by White et al ,2 Natelson et al ,12 and Mosier et al 20. Acute symptoms may not be registered if the patients die alone, and ischaemic changes in the heart may not be visible at necropsy unless they survive for more than 2 hours.…”

Section: Discussionmentioning

confidence: 99%

Sudden unexpected death in epilepsy (SUDEP): a clinical perspective and a search for risk factors

Kloster

Engelskjøn

1999

Journal of Neurology, Neurosurgery & Psychiatry

257

209

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Objectives-To examine the risk factors and their relative importance and possible role in sudden unexpected death in epilepsy (SUDEP). Methods-The study was conducted as a retrospective analysis of deaths in an outpatient population of a tertiary referral centre, based on clinical and pathological data. Results-Of a total of 140 deaths, 61 (44%) had not been to postmortem and were excluded, 37 (26%) had a verified cause of death and formed the non-SUDEP group, and 42 (30%) were classified as SUDEP. In the SUDEP group there was pulmonary oedema in 62%, signs of preceding seizures in 67%, no visible seizures in three of six observed deaths. A high seizure frequency prevailed in SUDEP as well as non-SUDEP. Sixty per cent of deaths were sleep related. Various other circumstances were temporally associated with death. The prone position at death was seen in 71% of the SUDEP patients; possible interpretations are discussed. Supposedly subtherapeutic serum concentrations of one or more antiepileptic drugs were found in 57% of those with reported serum concentrations. Alcohol was not a factor in the material, whereas hyponatraemia was seen in two cases. Conclusions-Most cases of SUDEP are preceded by seizures; their presence, frequency, type, aetiology, tractability, and the use of antiepileptic drugs are factors in the demise. No common risk factor, present in all cases of SUDEP, could be found, suggesting the probability of multiple mechanisms behind SUDEP. (J Neurol Neurosurg Psychiatry 1999;67:439-444)

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“…rally related t o paroxysmal cerebral activity. Mathew et al (1970) reported a 36-year-old man with a left frontal meningioma and no cardiac disease who had a single seizure, then was found to have atrial fibrillation that resolved in 8 h. Mosier et al (1957) reported that nine of 41 patients monitored during pentylenetetrazol-induced generalized seizures had cardiac dysrhythmias. They concluded that the dysrhythmias were "central in origin" because they occurred in spite of succinylcholine paralysis and controlled ventilation.…”

Section: Discussionmentioning

confidence: 99%

The Sudden Unexplained Death Syndrome in Epilepsy: Demographic, Clinical, and Postmortem Features

et al. 1992

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Sudden unexplained death syndrome (SUDS) accounts for about 10% of deaths in patients with epilepsy. It is associated with subtherapeutic postmortem serum antiepileptic drug (AED) levels but no anatomic cause of death on autopsy. The mechanisms of death are not known. We investigated 44 cases of SUDS for details of seizure history, treatment, medical and psychological history, events at the time of death, and postmortem findings. Cases of status epilepticus, drowning or other identifiable causes of death were excluded. Two groups emerged: five children with uncontrolled seizures receiving multiple AEDs and good compliance with medications, and 39 adults with less frequent seizures, often receiving monotherapy, but noncompliant with medications. Four children (80%) but only one adult (3%) had fully therapeutic postmortem AED levels. Sixty-three percent of adults recently had experienced an unusually stressful life event. Investigation of the circumstances at the time of death suggested two possible modes of death: (a) a seizure with an immediately fatal arrhythmia, or, (b) a seizure, recovery, then delayed secondary respiratory arrest or arrhythmia. Even though the mechanisms of death are unknown, the risk of SUDS may be reduced by encouraging patients to be compliant with medications, especially in times of unusual life stress.

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Cerebroautonomic and Myographic Changes Accompanying Induced Seizures

Cited by 16 publications

References 0 publications

Transient severe hypertension following alcohol withdrawal convulsions

Transient severe hypertension following alcohol withdrawal convulsions

Sudden unexpected death in epilepsy (SUDEP): a clinical perspective and a search for risk factors

The Sudden Unexplained Death Syndrome in Epilepsy: Demographic, Clinical, and Postmortem Features

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