Epilepsy and Autonomic Regulation

Matthias Dütsch, Max J. Hilz

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

3 Scopus citations

Abstract

This chapter focuses on epilepsy and autonomic regulation and various autonomic dysfunctions. A tightly interconnected central neuronal network causes a variety of clinical autonomic symptoms. The insula, anterior cingulate gyrus, and ventromedial prefrontal cortex are key areas of central autonomic function. The insula represents the primary viscerosensory cortex. Gastrointestinal symptoms such as nausea are frequent complaints during an aura. Current findings favor an insular or mesial temporal lobe origin of the subjective discomfort attributed to the epigastrium. Epilepsy associated respiratory autonomic dysfunction is less common than other autonomic symptoms. In newborns, however, apnea might be the sole epileptic symptom. Cardiovascular ictal dysfunction is the most prominent autonomic feature of epileptic seizures. Simultaneous video/EEG recordings that include an ECG trace demonstrated seizure-associated cardiac arrhythmia. Mortality rate of epilepsy patients is two to five times higher than of the general population. Sudden unexpected death in epilepsy (SUDEP) is considered the most common cause of death in epilepsy patients. Reduced cardiac uptake of Iodine meta-iodobenzylguanidine (MIBG) has been demonstrated interictally in patients with chronic temporal lobe epilepsy.

Original languageEnglish
Title of host publicationPrimer on the Autonomic Nervous System
PublisherElsevier Inc.
Pages549-552
Number of pages4
ISBN (Print)9780123865250
DOIs
StatePublished - 2012
Externally publishedYes

Keywords

  • Autonomic control
  • Epilepsy
  • Infratentorial central autonomic nervous system
  • Sudden unexplained death
  • Supratentorial central autonomic nervous system

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