Development of predictive tests and procedures for risk assessment of sudden death in epilepsy
Epileptic patients have an estimated 35% lifetime risk of sudden death. To put things in perspective, the risk of dying from cancer is much lower at roughly 22% in the general population. Sudden death during epilepsy (SUDEP) is a silent killer caused by cardiac rhythm disturbances (arrhythmias), often leaving resuscitated patients with major health complications.
We currently have no clinical tools to identify epileptic patients at risk to develop arrhythmias and since the mechanism causing death is unknown, no preventive therapy is available.
Our data indicate that during epilepsy, the heart has difficulty adapting its beating rate to variations in blood concentration of adrenaline. Studying how epileptic patients adapt their heart rate during exercise or injection of very low doses of epinephrine (adrenaline) should therefore provide clues to identify the ones with a higher risk of developing arrhythmias. Our overall aim is to identify the key signature on the electrocardiogram (ECG) of patients that could be used to establish their risk of developing lethal arrhythmias. In parallel, we also wish to verify if the changes in the response of the heart to adrenaline during epilepsy also translate into other cardiovascular effects. We believe our results will help improve diagnosis and eventually shed light on potential treatments for prevention of SUDEP.
Dr. Robert Dumaine
Université de Sherbrooke