Takotsubo syndrome (TKS): A possible mechanism of sudden unexplained death in epilepsy (SUDEP)

Abstract

We report a case of Takotsubo syndrome after epilepsy, and review the literature. We identified 59 cases of Takotsubo syndrome after focal or generalised epilepsy. As in Takotsubo syndrome in general, the patients were mostly female (84%), with a mean age of 63 years, and the evolution was generally favourable. There was one death and one stroke, and 4 cases were of relapsing Takotsubo after a new seizure. Takotsubo syndrome may induce cardiac arrhythmias. A near-SUDEP (sudden unexplained death in epilepsy) was reported in one patient. Animal models of SUDEP have shown similar cardiac lesions to those seen in Takotsubo syndrome, and strengthen the hypothesis of a link between these conditions. Takotsubo syndrome after epilepsy may be relatively common; we suggest measurement of serum troponin levels in high-risk patients and cardiac follow-up.

Takotsubo Cardiomyopathy Following Acute Cerebral Events

“…The prognosis of TCM is usually good with complete recovery within a few weeks, but TCM can also be associated with severe complications [21][22][23] such as cardioembolism, cardiac rupture and heart failure. Because of these potential complications, it seems essential to screen for TCM [24] , particularly in post-menopausal women with acute insular or vertebrobasilar stroke or an epileptic focus.…”

Potential links between neurological disease and Tako-Tsubo cardiomyopathy: A literature review

“…The clinical manifestation of TTC in these patients is a sudden hemodynamic deterioration either due to pump failure or due to arrhythmia. TTC after epilepsy may be relatively common; its estimated incidence is about 1% [37].…”

Takotsubo cardiomyopathy: a rare, but serious, complication of epileptic seizures

“…The majority of post-epileptic TKC cases are women, mean age 62.7 years. Epilepsy etiology may be varied 1 .…”

“…Incidence of TKC after epileptic seizures is unknown and could be related to cardiac death in epileptic patients 1 . The authors highlight the importance of suspecting TKC in patients with seizures and signs of cardiac dysfunction as subtle as sinus tachycardia.…”

“…Takotsubo cardiomyopathy (TKC) is a reversible, yet potentially fatal, syndrome triggered by stressful conditions, including seizures, with increasing recognition in clinical practice 1 . We report a TKC in a patient with unexplained sinus tachycardia and troponin elevation after generalized seizures.…”