Sudden unexpected death in epilepsy and ictal asystole in patients with autoimmune encephalitis: a systematic review.
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| Title: | Sudden unexpected death in epilepsy and ictal asystole in patients with autoimmune encephalitis: a systematic review. |
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| Authors: | Vogrig, Alberto (AUTHOR), Bellizzi, Fabrizio (AUTHOR), Burini, Alessandra (AUTHOR), Gigli, Gian Luigi (AUTHOR), Girardi, Luca (AUTHOR), Honnorat, Jérôme (AUTHOR), Valente, Mariarosaria (AUTHOR) |
| Source: | Neurological Sciences. Jun2024, Vol. 45 Issue 6, p2811-2823. 13p. |
| Subjects: | Sudden death, Epilepsy, Encephalitis, Cardiac arrest, Limbic system, Temporal lobe |
| Abstract: | Objective: As autoimmune encephalitis (AE) often involves the mesial temporal structures which are known to be involved in both sudden unexpected death in epilepsy (SUDEP) and ictal asystole (IA), it may represent a good model to study the physiopathology of these phenomena. Herein, we systematically reviewed the occurrence of SUDEP and IA in AE. Methods: We searched 4 databases (MEDLINE, Scopus, Embase, and Web of Science) for studies published between database inception and December 20, 2022, according to the PRISMA guidelines. We selected articles reporting cases of definite/probable/possible/near-SUDEP or IA in patients with possible/definite AE, or with histopathological signs of AE. Results: Of 230 records assessed, we included 11 cases: 7 SUDEP/near-SUDEP and 4 IA. All patients with IA were female. The median age at AE onset was 30 years (range: 15–65), and the median delay between AE onset and SUDEP was 11 months; 0.9 months for IA. All the patients presented new-onset seizures, and 10/11 also manifested psychiatric, cognitive, or amnesic disorders. In patients with SUDEP, 2/7 were antibody-positive (1 anti-LGI1, 1 anti-GABABR); all IA cases were antibody-positive (3 anti-NMDAR, 1 anti-GAD65). Six patients received steroid bolus, 3 intravenous immunoglobulin, and 3 plasmapheresis. A pacemaker was implanted in 3 patients with IA. The 6 survivors improved after treatment. Discussion: SUDEP and IA can be linked to AE, suggesting a role of the limbic system in their pathogenesis. IA tends to manifest in female patients with temporal lobe seizures early in AE, highlighting the importance of early diagnosis and treatment. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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