Repositório Institucional - Unifesp :: Navegando por Palavras-chave "sudden death"

Navegando por Palavras-chave "sudden death"

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Avaliação de parâmetros cardíacos em animais com epilepsia: possível causa de morte súbita?
(Academia Brasileira de Neurologia - ABNEURO, 2005-12-01) Colugnati, Diego Basile [UNIFESP]; Gomes, Paulo Alberto Paes; Arida, Ricardo Mario [UNIFESP]; Albuquerque, Marly de [UNIFESP]; Cysneiros, Roberta Monterazzo [UNIFESP]; Cavalheiro, Esper Abrão [UNIFESP]; Scorza, Fulvio Alexandre [UNIFESP]; Universidade de Mogi das Cruzes Núcleo de Pesquisas Tecnológicas; Universidade Federal de São Paulo (UNIFESP); UMC NPT Laboratório de Neurociências; Centro Universitário São Camilo; UMC
Among the causes for sudden death in epilepsy, cardiac dysfunction has been an area of interest. Based on this, the aim of our study was to evaluate the heart rate (in vivo and in vitro) and ventricular pressure in vitro of rats with epilepsy induced by pilocarpine. Adult male Wistar rats (n=6) were given pilocarpine hydrochloride to induce status epilepticus. Control rats (n=6) received saline solution instead pilocarpine. Our results showed significant differences in the mean of heart rate in vivo between the groups. In contrast, we did not find differences during in vitro experiments. Our results suggest a central nervous system modulation on the heart, which could explain the sudden unexpected death in epilepsy.
Somente Metadadados
Cardiomegaly is a common arrhythmogenic substrate in adult sudden cardiac deaths, and is associated with obesity
(Lippincott Williams & Wilkins, 2012-04-01) Tavora, Fabio [UNIFESP]; Zhang, Y.; Zhang, M.; Li, L.; Ripple, M.; Fowler, D.; Burke, Allen; Univ Maryland; Universidade Federal de São Paulo (UNIFESP); Armed Forces Inst Pathol
Background: Both coronary artery disease (CAD) and cardiomyopathy may present with sudden cardiac death (SCD). It is generally accepted that CAD is the most common cause of SCD in adults, but the frequency of cardiomegaly as a primary or contributing cause is less known.Methods: We retrospectively studied the cardiac findings of all cases of adult SCD attributed to cardiomegaly, severe atherosclerosis, or both, in the absence of specific cardiomyopathy. Association between findings and risk factors was studied.Results: There were 484 sudden cardiac deaths, of which 402 met study criteria. Mean age was 49 +/- 13 years, with 289 men and 159 African Americans (AAs). Cardiomegaly with presumed hypertensive, multifactorial or unknown cause, was the sole arrhythmogenic substrate in 38% of men and 49% of women (p = 0.003); CAD was the sole cause of SCD in 19% of men and 26% of women, and mixed CAD + cardiomegaly the cause of death in 43% of men and 25% of women. Cardiomegaly was associated by univariate analysis with younger age (46 +/- 12 years versus 53 +/- 14 for CAD, p < 0.0001), AA race (p = 0.004), and body mass index (p < 0.0001).Conclusions: Among adults with a mean age of about 50 years, cardiomegaly is a frequent cause of sudden cardiac death, and is highly associated with obesity. Cardiomegaly is also frequent in SCD with severe CAD. the causes and classification of cardiomegaly in patients without specific cardiomyopathy, and in patients with and without hypertension or coronary disease need to be better studied.
Acesso aberto (Open Access)
Does sudden unexpected death in children with epilepsy occur more frequently in those with high seizure frequency?
(Academia Brasileira de Neurologia - ABNEURO, 2009-12-01) Terra, Vera Cristina; Scorza, Fulvio Alexandre [UNIFESP]; Sakamoto, Américo Ceiki [UNIFESP]; Pinto, Kylvia Giselle Fernades Dantas; Fernandes, Regina Maria França; Arida, Ricardo Mario [UNIFESP]; Cavalheiro, Esper Abrão [UNIFESP]; Machado, Helio Rubens; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
People with epilepsy are more likely to die prematurely and the most common epilepsy-related category of death is sudden unexpected death in epilepsy (SUDEP). Several studies have reported a moderate or high seizure frequency among SUDEP cases and SUDEP is considered rare in patients in remission. METHOD: We reviewed the occurrence of SUDEP in our epilepsy unit over an 8-year period to identify a potential association between seizure frequency and SUDEP occurrence in children with epilepsy. RESULTS: From 835 patients evaluated, 12 had suffered SUDEP and nearly all of the SUDEP cases in our children are related to chronic uncontrolled epilepsy (daily - 50.0%, two to four/week - 41.7%, monthly - 8.3%). CONCLUSION: SUDEP is not a rare event in children and increased mortality was recorded in those individuals who had not responded to pharmacologic treatment. Improved seizure control seems to be one of the most important measures to prevent SUDEP.
Acesso aberto (Open Access)
Environmental air pollution is an aggravating event for sudden unexpected death in epilepsy
(Academia Brasileira de Neurologia - ABNEURO, 2013-10-01) Scorza, Carla Alessandra [UNIFESP]; Calderazzo, Lineu [UNIFESP]; Arida, Ricardo Mario [UNIFESP]; Cavalheiro, Esper Abrão [UNIFESP]; Scorza, Fulvio Alexandre [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
It is extremely difficult to estimate the occurrence of sudden unexpected death in epilepsy (SUDEP). On the other hand, discovering and carefully evaluating new risk factors that may contribute to the onset of cardiovascular abnormalities in people with refractory epilepsy may prevent fatal events in these individuals. In this context, we should not ignore that urban air pollution is a leading problem for environmental health and is able to cause serious cardiovascular dysfunctions that culminate in sudden death. In this regard, we aimed to determine whether environmental exposure to air pollution is an aggravating event for SUDEP.
Acesso aberto (Open Access)
Epilepsy and sudden unexpected death in epilepsy?: Eat more fish! A group hypothesis
(Academia Brasileira de Neurologia - ABNEURO, 2009-09-01) Cysneiros, Roberta Monterazzo [UNIFESP]; Terra, Vera Cristina; Machado, Helio Rubens; Arida, Ricardo Mario [UNIFESP]; Albuquerque, Marly de [UNIFESP]; Scorza, Carla Alessandra [UNIFESP]; Cavalheiro, Esper Abrão [UNIFESP]; Scorza, Fulvio Alexandre [UNIFESP]; Universidade Presbiteriana Mackenzie Centro de Ciências Biológicas e da Saúde Programa de Pós-Graduação em Distúrbios do Desenvolvimento; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
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.
Acesso aberto (Open Access)
Fish consumption, contaminants and sudden unexpected death in epilepsy: many more benefits than risks
(Instituto Internacional de Ecologia, 2010-08-01) Scorza, Fulvio Alexandre [UNIFESP]; Cysneiros, Roberta Monterazzo [UNIFESP]; Arida, Ricardo Mario [UNIFESP]; Terra, Vera Cristina; Machado, Helio Rubens; Rabello, Gmm. [UNIFESP]; Albuquerque, Marly de [UNIFESP]; Cavalheiro, Esper Abrão [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Presbiteriana Mackenzie Centro de Ciências Biológicas e da Saúde Programa de Pós-Graduação em Distúrbios do Desenvolvimento; Universidade de São Paulo (USP)
People with epilepsy have an increased risk of dying prematurely and the most common epilepsy-related category of death is sudden unexpected death in epilepsy (SUDEP). SUDEP is mainly a problem for patients with chronic uncontrolled epilepsy. The ultimate goal of research in SUDEP is to develop new methods to prevent it and actions other than medical and surgical therapies that could be very useful. Nutritional aspects, i.e., omega-3 fatty acids deficiency, could have an interesting role in this scenario. Some animal and clinical studies have suggested that omega-3 fatty acids could be useful in the prevention and treatment of epilepsy and hence SUDEP. It has been ascertained that the only foods that provide large amounts of omega-3 are seafood (fish and shellfish); however, some fish are contaminated with methylmercury, which may counteract the positive effects of omega-3 fatty acids. Our update review summarises the knowledge of the role of fish consumption on epilepsy research.
Acesso aberto (Open Access)
Is there something special about cardiovascular abnormalities and sudden unexpected death in epilepsy among patients with chronic renal insufficiency in regular hemodialysis program?
(Academia Brasileira de Neurologia - ABNEURO, 2009-06-01) Gomes, Rui A. [UNIFESP]; Kesrouani, Silvana; Cruz, Jenner; Silva, Alexandre L.; Henriques, Tânia M.g.; Albuquerque, Marly de [UNIFESP]; Arida, Ricardo Mario [UNIFESP]; Sonoda, Eliza Yumi de Freitas [UNIFESP]; Cysneiros, Roberta Monterazzo [UNIFESP]; Terra, Vera Cristina; Scorza, Carla Alessandra [UNIFESP]; Cavalheiro, Esper Abrão [UNIFESP]; Scorza, Fulvio Alexandre [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Instituto de Nefrologia de Mogi das Cruzes; Universidade Mackenzie Programa de Pós-Graduação em Distúrbio do Desenvolvimento; Universidade de São Paulo (USP)
Of the many risk factors suggested for sudden unexpected death in epilepsy (SUDEP), higher frequency of seizures is a very consistent issue. Following this reasoning, it has been established that hemodialysis-associated seizure is a complication of dialysis procedure. Based on these facts, this study investigated a possible association between cardiovascular abnormalities and SUDEP among patients with chronic renal insufficiency in regular hemodialysis program. For that, a retrospective medical history of 209 patients was reviewed to investigate the occurrence of convulsive seizures and EKG abnormalities during dialytic program. Three patients presented generalized tonic-clonic seizures, one had partial seizure with secondary generalization, and one presented unclassified seizure. Any EKG abnormalities and SUDEP event were found in all patients evaluated. In conclusion, the present findings demonstrated uncommon the occurrence of seizures and also SUDEP. Probably, the main justification to not allow us to demonstrated a direct relation between SUDEP and cardiovascular diseases in hemodialysis are the reduced number of cases examined.
Acesso aberto (Open Access)
May the best friend be an enemy if not recognized early: possible role of omega-3 against cardiovascular abnormalities due antipsychotics in the treatment of autism
(Academia Brasileira de Neurologia - ABNEURO, 2009-09-01) Cysneiros, Roberta Monterazzo [UNIFESP]; Terra, Vera Cristina; Machado, Helio Rubens; Arida, Ricardo Mario [UNIFESP]; Schwartzman, José Salomão; Cavalheiro, Esper Abrão [UNIFESP]; Scorza, Fulvio Alexandre [UNIFESP]; Universidade Presbiteriana Mackenzie Centro de Ciências Biológicas e da Saúde Distúrbios do Desenvolvimento; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
Autism spectrum disorders (ASD) are neurodevelopment disorders that cause severe and pervasive impairment in socialization, communication, and behavior. Although the availability of antipsychotic treatment in ASD has expanded, we will be very careful with side effects of these pharmacological agents. Following this reasoning, emerging data indicate that some antipsychotics may be associated with cardiovascular adverse events (e.g., QT interval prolongation), suggesting that this could be correlated to sudden death. Quite interesting, substantial evidence from epidemiological and case-control studies indicates that omega-3 reduces the risk of cardiovascular mortality, particularly sudden cardiac death. In accordance to the above mentioned findings, as omega-3 fatty acids per se have a direct cardiovascular protective role, our paper hypothesized that omega-3 fatty acids supplementation in ASD patients treated with atypical antipsychotic drugs may reduce cardiac arrhythmias and hence sudden cardiac death.
Acesso aberto (Open Access)
Mortality in children with severe epilepsy: 10 years of follow-up
(Academia Brasileira de Neurologia - ABNEURO, 2011-10-01) Terra, Vera Cristina; Scorza, Fulvio Alexandre [UNIFESP]; Arida, Ricardo Mario [UNIFESP]; Fernandes, Regina Maria França; Wichert-Ana, Lauro; Machado, Helio Rubens; Sakamoto, Américo Ceiki [UNIFESP]; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
Epilepsy is the main neurological condition in children and adolescents. Unfortunately patients with medical refractory epilepsy are more susceptible for clinical complications and death. We report a prospectively evaluated cohort of children followed for approximately 10 years. Fifty-three of 1012 patients died. Forty-two patients died due to epilepsy or its clinical complications and the main causes of death were pneumonia (in 16 cases), sepses (in 9 patients), status epilepticus (in 8 patients). In 11 patients cause of death was sudden unexpected death in epilepsy (SUDEP). Mental retardation was significantly more frequent in patients who did not die from SUDEP. SUDEP may be a significant condition associated with mortality in children and adolescents with epilepsy.
Acesso aberto (Open Access)
Níveis cardíacos de troponina I em pacientes com epilepsia do lobo temporal refratária após cortico-amígdalo-hipocampectomia
(Liga Brasileira de Epilepsia (LBE), 2007-03-01) Colugnati, Diego Basile [UNIFESP]; Cukiert, Arthur; Matos, Wilna Klecia Lima; Albuquerque, Marly de [UNIFESP]; Arida, Ricardo Mario [UNIFESP]; Cavalheiro, Esper Abrão [UNIFESP]; Cysneiros, Roberta Monterazzo [UNIFESP]; Pansani, Aline Priscila [UNIFESP]; Almeida, Antonio-carlos Guimarães de; Baldauf, Cristine; Argentoni-Baldochi, Meire; Baise-Zung, Carla; Scorza, Fulvio Alexandre [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de Mogi das Cruzes Núcleo de Pesquisas Tecnológicas; Hospital Brigadeiro Departamento de Neurologia e Neurocirurgia; Centro Universitário São Camilo; Hospital Israelita Albert Einstein; Universidade Federal de São João del-Rei Departamento de Engenharia Biomédica
PURPOSE: Sudden unexpected death in epilepsy (SUDEP) is the main cause of death in patients with epilepsy. Morphologic and functional changes in the heart are related to SUDEP. The aim of our study was to verify the concentration of troponin I, an important marker of myocardium damage, in patients with temporal lobe epilepsy who were submitted to surgical resection and were not seizure-free after the procedure. METHODS: Eleven non-consecutive patients participated in the study and all of them presented poor seizure control after surgical procedure. Troponin I levels higher then 1 ng/ml indicate myocardium damage. The detection level of the kit used in our study was 0,15 ng/ml. RESULTS: Only three patients showed detectable troponin I levels. The troponin I levels found in our study is not related with sex, age or side of the lesion. CONCLUSIONS: In spite of we did not find positive results in our study, an active role of the heart in SUDEP cannot be discarded, since some injuries, even so not being capable to modify troponin I levels, can be enough to generate arrhythmogenic foci.
Somente Metadadados
The other side of the coin: Beneficiary effect of omega-3 fatty acids in sudden unexpected death in epilepsy
(Elsevier B.V., 2008-08-01) Scorza, Fulvio A. [UNIFESP]; Cysneiros, Roberta M.; Arida, Ricardo M. [UNIFESP]; Terra-Bustamante, Vera C.; Albuquerque, Marly de; Cavalheiro, Esper A. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); NPT UMC; Univ Presbiteriana Mackenzie
The epilepsies are the most common serious neurological condition. People with epilepsy have a two- to threefold increased risk of dying prematurely than those without epilepsy, and the most common epilepsy-related category of death is sudden unexpected death in epilepsy (SUDEP). the exact pathophysiological causes of SUDEP remain unknown, but it is very probable that cardiac arrhythmia during and between seizures plays a potential role. Although the pharmacological treatments available for the epilepsies have expanded, antiepileptic drugs are still limited in clinical efficacy. in this regard, several factors such as genetic, environmental, and social can contribute to the inefficacy of therapeutic outcome in patients with epilepsy. Among these factors, nutritional aspects, that is, omega-3 fatty acid deficiency, have an interesting role in this scenario. Animal and clinical studies have demonstrated that omega-3 fatty acids may be useful in the prevention and treatment of epilepsy. Moreover, as omega-3 fatty acids per se have been shown to reduce cardiac arrhythmias and sudden cardiac deaths, it has been proposed that omega-3 fatty acid supplementation in patients with refractory seizures may reduce seizures and seizure-associated cardiac arrhythmias and, hence, SUDEP. Given their relative safety and general health benefits, our update article summarizes the knowledge of the role of dietary omega-3 fatty acids in epilepsy. (c) 2008 Elsevier Inc. All rights reserved.
Acesso aberto (Open Access)
Serum levels of magnesium in sudden cardiac deaths among people with schizophrenia: hit or miss?
(Academia Brasileira de Neurologia - ABNEURO, 2012-10-01) Scorza, Fulvio Alexandre [UNIFESP]; Albuquerque, Marly de [UNIFESP]; Arida, Ricardo Mario [UNIFESP]; Cysneiros, Roberta Monterazzo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Presbiteriana Mackenzie
Schizophrenia is a devastating mental disorder, affecting cognitive, emotional, and behavioral conditions, ability to work, social functioning, family stability and self-esteem of the patient. People with schizophrenia show a two to three-fold increased risk to die prematurely than those without schizophrenia. Understanding the mechanisms behind sudden cardiac death in individuals with schizophrenia is a key to prevention. Although different mechanisms may be related, there are clear indications that cardiac abnormalities play a potential role. Some antipsychotics may be associated with cardiovascular adverse events, e.g., QT interval prolongation, metabolic dysfunction, blood pressure and heart rate alterations. Magnesium (Mg) abnormalities may lead to various morphological and functional dysfunctions of the heart and low levels of serum Mg are considered to be at high risk for sudden cardiac death. As low serum Mg is associated with detrimental effects on the heart and that antipsychotic-treated schizophrenia patients frequently affect the heart rate, possibly, these factors together must change the normal functioning of the heart and consequently being able to culminate in a catastrophic event.
Acesso aberto (Open Access)
Serum magnesium: a clinical biomarker for sudden unexpected death in epilepsy?
(Liga Brasileira de Epilepsia (LBE), 2011-01-01) Terra, Vera Cristina; Albuquerque, Marly de [UNIFESP]; Scorza, Carla Alessandra [UNIFESP]; Arida, Ricardo Mario [UNIFESP]; Scorza, Fulvio Alexandre [UNIFESP]; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
INTRODUCTION: Epilepsy is one of the most common chronic neurological disorder in the world and has a higher mortality rate than would be expected in a healthy population. One of the most related category of death is sudden unexpected death in epilepsy (SUDEP). Many risk factors have been related to SUDEP, but the mechanisms involved in its genesis is still unknown. OBJECTIVE: Here we describe one case of a patient with low serum magnesium levels that suffered of SUDEP. CONCLUSION: we discuss a possible cause-effect relation, suggesting that magnesium may be, in some cases, a biomarker of SUDEP.
Acesso aberto (Open Access)
Sudden unexpected death in an adolescent with epilepsy: All roads lead to the heart?
(Via Medica, 2011-03-01) Pinto, Kylvia G. F. D.; Scorza, Fulvio Alexandre [UNIFESP]; Arida, Ricardo Mario [UNIFESP]; Cavalheiro, Esper Abrão [UNIFESP]; Martins, Luciana D.; Machado, Helio R.; Sakamoto, Américo Ceiki [UNIFESP]; Terra, Vera C.; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
The incidence of sudden unexpected death in epilepsy (SUDEP) has been estimated from 0.5-1.4/1,000 person-years in people with treated epilepsy, and 9/1,000 person-years in candidates for epilepsy surgery. Potential risk factors for SUDEP include: age, early onset of epilepsy, duration of epilepsy, uncontrolled seizures, seizure type and winter temperatures. The arrythmogenic side-effect of antiepileptic drugs and seizures may increase the risk of SUDEP. In this report, we describe a patient with prolonged post-ictal tachycardia in EEG video recordings with a typical case of SUDEP: a 16-year-old boy with medically intractable complex partial seizures. Magnetic resonance imaging revealed left mesial temporal sclerosis. During non-invasive video-EEG monitoring, the patient presented a post-ictal heart rate increased for five hours. Two months after video-EEG, he died from SUDEP during a tonic-clonic secondary generalized seizure. The possibility of cardiac involvement in the pathogenesis of SUDEP has been suggested by many studies. Evaluation of this patient with EEG-video monitoring, including measurement of heart rate, contributed to an identification of ictal tachycardia that may have played a role in the SUDEP. Premature mortality seems to be increased in patients with epilepsy, and cardiac abnormalities may be a possible cause of SUDEP. (Cardiol J 2011; 18, 2: 194-196)
Acesso aberto (Open Access)
The utility of omega-3 fatty acids in epilepsy: more than just a farmed tilapia!
(Academia Brasileira de Neurologia - ABNEURO, 2011-02-01) Terra, Vera Cristina; Arida, Ricardo Mario [UNIFESP]; Rabello, Guilherme M. [UNIFESP]; Cavalheiro, Esper Abrão [UNIFESP]; Scorza, Fulvio Alexandre [UNIFESP]; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
The epilepsies are one of the most common serious brain disorders and 20 to 30% of people developing epilepsy continue to have seizures and are refractory to treatment with the currently available therapies. Approximately one in a 1000 patients with chronic epilepsy will die suddenly, unexpectedly, and without explanation, even with post-mortem examination and this phenomenon is called sudden unexplained death in epilepsy (SUDEP). Understanding the mechanisms underlying SUDEP may lead to the identification of previously unrecognized risk factors that are more amenable to correction. We discuss here the possible implications of omega-3 fatty acids consumption on SUDEP prevention.
Acesso aberto (Open Access)
When your child with epilepsy die suddenly: febrile seizures are part of the process?
(Academia Brasileira de Neurologia - ABNEURO, 2011-01-01) Terra, Vera Cristina; Machado, Helio Rubens; Sakamoto, Américo Ceiki [UNIFESP]; Arida, Ricardo Mario [UNIFESP]; Scorza, Fulvio Alexandre [UNIFESP]; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
Febrile seizures (FS) affect almost 2-5% of children and factors related to an increase susceptibility of children to FS may involve an imbalance of inflammatory cytokines and genetic factors. FS had low morbidity, but may be associated with the occurrence of late chronic epilepsy. Here we describe factors related to FS and its possible correlation with SUDEP.

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