REVIEW PAPER
Clinical considerations on the relationship between epilepsy and cardiovascular diseases
 
More details
Hide details
1
Chair and Department of Internal Medicine, Medical University, Lublin, Poland
2
Chair and Department of Obstetrics and Perinatology, Medical University, Lublin, Poland
3
Chair and Department of Cardiology, Medical University, Lublin, Poland
4
Department of Pathophysiology, Medical University, Lublin, Poland; Department of Physiopathology, Institute of Agricultural Medicine, Lublin, Poland
CORRESPONDING AUTHOR
Stanisław Czuczwar   

Department of Pathophysiology, Medical University, Lublin, Jaczewskiego 8, 20-090 Lublin, Poland
 
J Pre Clin Clin Res. 2007;1(1):6–8
KEYWORDS
ABSTRACT
There have been reports regarding higher risk of unexpected death in epileptic patients. The aim of this review is to investigate causes of epilepsy-related death with special attention to cardiovascular mechanisms. Due to their high incidence among the general population, epilepsy and cardiovascular diseases are likely to coexist in a certain proportion of patients. The effect of calcium channel antagonists – representing drugs commonly used in cardiac pathology – on seizure control is also discussed on the basis of available experimental data.
 
REFERENCES (40)
1.
Sander JWAS, Shovron SD: The epidemiology of the epilepsies. J Neurol Neurosurg Psychiatry 1996, 61, 433-443.
 
2.
Zdrojewski T, Wyrzykowski B, Szczech R, Wierucki L, Naruszewicz M, Narkiewicz K, Zarzeczna-Baran M, Steering Committees of the Programmes NATPOL PLUS, SMS, The Polish 400-Cities Project: Epidemiology and prevention of arterial hypertension in Poland. Blood Press Suppl 2005, 2, 10-16.
 
3.
Murray CJ, Lopez AD: Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet 1997, 349, 1436- 1442.
 
4.
Ficker DM, So EL, Shen WK, Annegers JF, O´Brien C, Cascino PGD, Belau PG: Population-based study of the incidence of sudden unexplained death in epilepsy. Neurology 1998, 51, 1270-1274.
 
5.
Basile J: The role of existing and newer calcium channel blockers in the treatment of hypertension. J Clin Hypertens 2004, 6, 621-629.
 
6.
Opie LH: Calcium channel blockers in hypertension: reappraisal after new trials and major meta-analyses. Am J Hypertens 2001, 14, 1074- 1081.
 
7.
Grossman E, Messerli FH: Calcium antagonists. Prog Cardiovasc Dis 2004, 47, 34-57.
 
8.
Romero M, Sanchez I, Pujol MD: New advances in the field of calcium channel antagonists: cardiovascular effects and structure-activity relationships. Curr Med Chem Cardiovasc Hematol Agents 2003, 1, 113-141.
 
9.
Katz AM.: Calcium channel diversity in the cardiovascular system. JACC 1996, 28, 522-529.
 
10.
Fox AP, Nowycky MC, Tsien RW: Kinetic and pharmacological properties distinguishing three types of calcium currents in chick sensory neurones. J Physiol 1987, 394, 149-172.
 
11.
Overweg J, Binnie CD, Meijer JW, Meinardi H, Nuijten ST, Schmaltz S, Wauquier A: Double-blind placebo-controlled trial of flunarizine as add-on therapy in epilepsy. Epilepsia 1984, 25, 217-222.
 
12.
Binnie CD: Flunarizine in epilepsy. Ann of NY Acad Sci 1988, 522, 710-711.
 
13.
Overweg J, Binnie CD: Clinical treatment of epilepsy with calcium entry blockers. Funct Neurol 1986, 1, 539-541.
 
14.
Southam E, Stratton SC, Davies CH: Anticonvulsant mechanisms for today and tomorrow. Drug News Perspect 2005, 18, 483-487.
 
15.
Borowicz KK, Gąsior M, Kleinrok Z, Czuczwar SJ: Influence of isradipine, niguldipine and dantrolene on the anticonvulsive action of conventional antiepileptics in mice. Eur J Pharmacol 1997, 323, 45- 51.
 
16.
Czuczwar SJ, Chodkowska A, Kleinrok Z, Małek U, Jagiełło-Wójtowicz E: Effects of calcium channel inhibitors upon the efficacy of common antiepileptic drugs. Eur J Pharmacol 1990, 176, 75-83.
 
17.
Czuczwar SJ, Gąsior M, Janusz W, Kleinrok Z: Influence of flunarizine, nicardipine and nimodipine on the anticonvulsant activity of different antiepileptic drugs in mice. Neuropharmacology 1992, 31, 1179-1183.
 
18.
Kamiński R, Jasiński M, Jagiełło-Wójtowicz E, Kleinrok Z, Czuczwar SJ: Effect of amlodipine upon the protective activity of antiepileptic drugs against maximal electroshock-induced seizures in mice. Pharmacol Res 1999, 40, 319-325.
 
19.
Borowicz KK, Kleinrok Z, Czuczwar SJ: Niguldipine impairs the protective activity of carbamazepine and phenobarbital in amygdalakindled seizures in rats. Eur Neuropsychopharmacol 2002, 12, 225- 233.
 
20.
Benavente-Aguilar I, Morales-Blanquez C, Rubio EA, Rey JM: Quality of life of adolescents suffering from epilepsy living in the community. J Paediat Child Health 2004, 40, 110-113.
 
21.
McEwan MJ, Espie CA, Metcalfe J, Brodie MJ, Wilson MT: Quality of life and psychosocial development in adolescents with epilepsy: a qualitative investigation using focus group methods. Seizure 2004, 13, 15-31.
 
22.
Nakane Y, Seino M, Yaqi K, Kaji S, Yamauchi T: Effects of flunarizine on intractable epilepsy. Arzneimittelforschung 1989, 39, 793-798.
 
23.
Czuczwar SJ: Doświadczalne podstawy racjonalnej politerapii. Epileptologia 1998, 6, 231-247.
 
24.
Annegers JF, Coan PS: SUDEP: overview of definitions and review of incidence data. Seizure 1999, 8, 347-352.
 
25.
Racoosin JA, Feeney J, Burkhart G, Boehm G: Mortality in antiepileptic drug development programs. Neurology 2001, 56, 514-519.
 
26.
Bell GS, Sander JW: Sudden unexpected death in epilepsy. Risk factors, possible mechanisms and prevention: a reappraisal. Acta Neurol Taiwan 2006, 15, 72-83.
 
27.
Freeman R: Cardiovascular manifestations of autonomic epilepsy. Clin Auton Res 2006, 16, 12-17.
 
28.
Lathers CM, Schraeder PL: Clinical pharmacology: drugs as a benefitand/or risk in sudden unexpected death in epilepsy? J Clin Pharmacol 2002, 42, 123-136.
 
29.
Tigaran S, Molgaard H, McClelland R, Dam M, Jaffe AS: Evidence of cardiac ischemia during seizures in drug refractory epilepsy patients Neurology 2003, 60, 492-495.
 
30.
Walczak T: Do antiepileptic drugs play a role in sudden unexpected death in eplilepsy? Drug Safety 2003, 26, 673-683.
 
31.
Zijlmans M, Flanagan D, Gotman J: Heart rate changes and ECG abnormalities during epileptic seizures: prevalence and definition of an objective clinical sign. Epilepsia 2002, 43, 847-854.
 
32.
Lathers CM, Schraeder PL, Weiner FL: Synchronization of cardiac autonomic neural discharge with epileptogenic activity: the lockstep phenomenon. Electroencephalogr Clin Neurophysiol 1987, 67, 247- 259.
 
33.
Van Amelsvoort T, Bakshi R, Devaux CB, Schwabe S: Hyponatremia massociated with carbamazepine and oxcarbazepine therapy: a review. Epilepsia 1994, 35, 181-188.
 
34.
Schmidt D, Sachdeo R: Oxcarbazepine for treatment of partial epilepsy: a review and recommendations for clinical use. Epilepsy Behav 2000, 1, 396-405.
 
35.
Rocamora R, Kurthen M, Lickfett L, von Oertzen J, Elger CE: Cardiac asystole in epilepsy: clinical and neurophysiologic features. Epilepsia 2003, 44, 179-185.
 
36.
Stőllberger C, Finsterer J: Cardiorespiratory findings in sudden unexplained/unexpected death in epilepsy (SUDEP). Epilepsy Res 2004, 59, 51-60.
 
37.
Devinsky O, Pacia S, Tatambhotla G: Bradycardia and asystole induced by partial seizures: a case report and literature review. Neurology 1997, 6, 1712-1714.
 
38.
Nilsson L, Diwan V, Farahmand BY, Persson PG, Tomson T: Antiepileptic drug therapy and its management in sudden unexpected death in epilepsy: a case-control study. Epilepsia 2001, 42, 667-673.
 
39.
Leestma JE, Annegers JF, Brodie MJ, Brown S, Schraeder P, Siscovick D, Wannamaker BB, Tennis PS, Cierpial MA, Earl NL: Sudden unexplained death in epilepsy: observations from a large clinical development program. Epilepsia 1997, 38, 47-55.
 
40.
Ng SKC, Hauser WA, Burst JCM, Susser M: Hypertension and risk of new-onset unprovoked seizures. Neurology 1993, 43, 425-428.
 
eISSN:1898-7516
ISSN:1898-2395