Epilepsy and sudden unexpected death in epilepsy?: Eat more fish! A group hypothesis

Abstract

-Epilepsy is the commonest serious neurological disorder and individuals with epilepsy are at higher risk of death than the general population and sudden unexpected death in epilepsy (SUDEP) is the most important direct epilepsy-related cause of death. Potential pathomechanisms for SUDEP are unknown, but it is very probable that cardiac arrhythmias during and between seizures play a potential role. The ultimate goal of SUDEP research is to develop methods to prevent it and nutritional aspects such as omega-3 fatty acid deficiency may have an interesting role in this scenario. Omega-3 fatty acids reduce the risk of cardiovascular mortality and are important for treating or preventing some neurological diseases, including epilepsy. A dietary modification or nutritional supplements increasing the ingestion of omega-3 fatty acids may help to ''save the brain".KEY WORDS: epilepsy, sudden death, omega-3. Epilepsia e morte súbita? Coma mais peixe! A hipótese de um grupoResumo -A epilepsia é uma das doenças neurológicas sérias mais comuns e está associada a um maior risco de morte do que o observado na população geral e a morte súbita em epilepsia é uma importante causa de morte relacionada à epilepsia. Os potenciais patomecanismos da morte súbita em epilepsia são desconhecidos, mas é bastante provável que arritmias cardíacas durante ou entre as crises tenham um papel preponderante. O objetivo final das pesquisas em morte súbita em epilepsia é o desenvolvimento de métodos que levem à sua prevenção e aspectos nutricionais, como a deficiência de ômega-3 pode ter um papel interessante neste contexto. A suplementação com ômega-3 reduz o risco de mortalidade de origem cardiovascular e é importante no tratamento e prevenção de algumas doenças neurológicas, incluindo a epilepsia. A modificação dietética ou a suplementação nutricional aumentando a ingesta de ômega-3 pode ajudar a "salvar o cérebro".

Assessing the association between supplemented puppyhood dietary fat sources and owner-reported epilepsy in adulthood, among Finnish companion dogs

“…Deficiency of fatty acids during the pre- and early postnatal life periods has been associated with a delay in the growth and maturation of the myelin in the brain frontal lobe of offspring ( 74 ). In seizure disorder, n-3 PUFA supplementation has been found to promote neuroprotection ( 75 ). The n-3 PUFA can play a vital role in neuronal functions throughout the life via several proposed mechanisms ( 76 ) including maintaining the cell membrane liquidity ( 77 ), myelination ( 78 ), neural growth, gene expression ( 76 ), and its anti-inflammatory properties ( 79 ).…”

The effect of maternal omega-3 fatty acid supplementation on behaviour and kindling rates of seizure-prone and seizure-resistant offspring

“…While a precise FA deficiency has not been linked with the development of SD, research (discussed below) has indicated omega-3 supplementation leads to a decrease in severity of symptoms and promotes neuroprotection (Cysneiros et al, 2009), thus indicating EFAs may play a role in seizure disorders (Scorza et al, 2008;Tavriger, 1966;Yuen & Sander, 2004;Yuen et al, 2005).…”

“…The investigation into the efficacy of omega-3 FA supplementation as a treatment for epilepsy has also yielded mixed results (Cysneiros, et al, 2009;Ferrari, et al, 2008;Yuen & Sander, 2004;Yuen, et al, 2005). Supplementation of a DHA/EPA mixture leads to an increase in blood concentrations of DHA and EPA, as well as reduced seizure susceptibility, however, decreased seizure frequency was only sustained for the first half of a twelve week study by Yuen et al (2005).…”

“…A thirteen month study involving DHA/EPA supplementation found increased blood serum levels of DHA accompanied by decreased seizure duration and severity in epileptic patients (Ferrari, et al, 2008;Scorza, et al, 2008;Yuen & Sander, 2004). Furthermore, supplementation research has indicated associated treatment effects are due to increased neuroprotection associated with inflated omega-3 FA levels (Cysneiros, et al, 2009).…”