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Brain and Heart Dynamics pp 1–10Cite as

Epilepsy and Cardiovascular Function

Seizures and Antiepileptic Drugs Effects

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Abstract

Epilepsy is a chronic neurological disorder, characterized by predisposition to recurrent seizures. Epilepsy patients show an increased mortality rate, and cardiovascular disease is a significant cause of death.

The interrelationship between epilepsy and hearth is complex and many physiopathological aspects still remain unclear. Epilepsy may induce both acute and chronic cardiac changes.

The Central Autonomic Network (CAN) includes cortical, subcortical, hypothalamic, and subthalamic regions which control the activity of preganglionic sympathetic and parasympathetic neurons; activation or deactivation of CAN may be responsible for cardiac changes related to seizures. Acute cardiac effects of seizures include ictal tachycardia, ictal bradycardia syndrome (including bradycardia and asystole), postictal asystole, postictal atrial, and ventricular fibrillation; periictal QT changes, cardiac ischemia, and acute stress cardiomyopathy are also described.

Chronic cardiac changes include reduced interictal heart rate variability and QT interval modifications. Both acute and chronic factors may be involved in the pathogenesis of SUDEP.

Many drugs, i.e., Phenitoin, Carbamazepine, Lamotrigine, Lacosamide, have been associated with cardiac side effects. Levetiracetam, Valproic Acid, and other AEDs are relatively free of any untoward cardiac effect.

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Author information

Authors and Affiliations

  1. Sleep Medicine and Epilepsy Unit, IRCCS Mondino Foundation, Pavia, Italy

    Raffaele Manni, Gianpaolo Toscano & Michele Terzaghi

  2. Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy

    Gianpaolo Toscano & Michele Terzaghi

Authors
  1. Raffaele Manni
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  2. Gianpaolo Toscano
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  3. Michele Terzaghi
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Corresponding author

Correspondence to Raffaele Manni .

Editor information

Editors and Affiliations

  1. Dept of Drug Sciences, Pharmacology Sect, University of Pavia, Dept of Drug Sciences, Pharmacology Sect, Pavia, Pavia, Italy

    Stefano Govoni

  2. Dept of Brain and Behavioural Sciences, University of Pavia Dept of Brain and Behavioural Sciences, Pavia, Pavia, Italy

    Pierluigi Politi

  3. Department of Molecular Medicine, University of Pavia, Department of Molecular Medicine, Pavia, Pavia, Italy

    Emilio Vanoli

Section Editor information

  1. Istituto Neurologico Nazionale ‘C. Mondino’, Pavia, Italy

    Roberto Bergamaschi

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Manni, R., Toscano, G., Terzaghi, M. (2019). Epilepsy and Cardiovascular Function. In: Govoni, S., Politi, P., Vanoli, E. (eds) Brain and Heart Dynamics. Springer, Cham. https://doi.org/10.1007/978-3-319-90305-7_30-1

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  • DOI: https://doi.org/10.1007/978-3-319-90305-7_30-1

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  • Print ISBN: 978-3-319-90305-7

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