Mazzola Laure, Rheims Sylvain
Neurology Department, University Hospital, Saint-Étienne, France.
Lyon Neuroscience Research Center, INSERM U 1028, CNRS UMR, Lyon, France.
Front Neurol. 2021 Mar 12;12:642645. doi: 10.3389/fneur.2021.642645. eCollection 2021.
There is a complex interrelation between epilepsy and cardiac pathology, with both acute and long-term effects of seizures on the regulation of the cardiac rhythm and on the heart functioning. A specific issue is the potential relation between these cardiac manifestations and the risk of Sudden and Unexpected Death in Epilepsy (SUDEP), with unclear respective role of centrally-control ictal changes, long-term epilepsy-related dysregulation of the neurovegetative control and direct effects on the heart function. In the present review, we detailed available data about ictal cardiac changes, along with interictal cardiac manifestations associated with long-term functional and structural alterations of the heart. Pathophysiological mechanisms of these cardiac changes are discussed, with a specific focus on central mechanisms and the investigation of a possible deregulation of the central control of autonomic functions in addition to the role of catecholamine and hypoxemia on heart.
癫痫与心脏病理之间存在复杂的相互关系，癫痫发作对心律调节和心脏功能既有急性影响，也有长期影响。一个具体问题是这些心脏表现与癫痫性猝死（SUDEP）风险之间的潜在关系，中枢控制的发作期变化、与癫痫相关的长期神经植物神经控制失调以及对心脏功能的直接影响各自的作用尚不清楚。在本综述中，我们详细介绍了有关发作期心脏变化的现有数据，以及与心脏长期功能和结构改变相关的发作间期心脏表现。讨论了这些心脏变化的病理生理机制，特别关注中枢机制，并研究除了儿茶酚胺和低氧血症对心脏的作用外，自主神经功能中枢控制可能的失调情况。
