Epilepsy & Heart Failure

[Porkette]

Hi Folks,

Have any of you ever heard of having epilepsy for yrs. leading to heart failure? I saw my neuro for my check up and I was told that he feels that
the damage on my brain is do to yrs. of seizures which can cause heart failure. I've never heard of this and I was just wondering if anyone else has ever
heard of epilepsy leading to heart failure. Thank you for your time and May God Bless You!

Sue

 

[Cint]

I certainly have heard of seizures leading to heart failure, especially in cases of Sudden Unexplained Death In Epilepsy Patients. I've met a mother who lost her daughter to SUDEP before being told these awful facts. It seems that docs are still reluctant to tell the truth, so read here for more info:

http://www.epilepsy.com/learn/impact/mortality/sudep/how-sudep-occurs

There are several ways in which changes in heart function may contribute to SUDEP.

Seizures are known to affect heart rhythms. Usually a person's heart rate increases during a seizure. One study found that a greater degree of heart rate increase with a seizure was associated with a greater risk of SUDEP. Less often, the heart rate can slow down too much during or after a seizure. Irregular heart rhythms or even periods without a heart beat can also occur. Some individuals with abnormal heart rhythms recorded during seizures have had pacemakers implanted to protect against future heart rhythm problems.
Severe seizures may also cause Takotsubo Syndrome, a condition in which the heart muscle does not function properly after a severe stress. About 8 % of people with Takotsubo Syndrome die from heart failure, shock, irregular heart rhythms, blood clots or sudden death. Long-term changes in the structure of the heart have also been described in some people with epilepsy but how this relates to SUDEP is not known.

 

[Nakamova]

There hasn't been enough research to be conclusive, but it seems pretty likely that there would be some sort of causal connection, with a long-term seizure history playing at minimum a contributing role. In cases of SUDEP (which is rare, but extremely important for people w. epilepsy to be aware of), they've found cardiac fibrosis (thickening of the heart muscle which can lead to heart failure) and other kinds of heart damage that might be associated with the surge of adrenaline and norepinephrine that occurs during a tonic-clonic seizure. So one possible scenario is that multiple seizures could damage the heart over time, especially if you are extra-vulnerable to heart problems (say, due to genetic factors or other health issues).

It's also worth noting that the long-term use of some of the older anti-epileptic medications is ALSO associated with heart damage. Those meds are "enzyme-inducing" and include the following: phenytoin (Dilantin), phenobarbital, carbamazepine (Tegretol), and primidone (Mysoline). So the task of pinpoint a single causative factor is tricky.

I hope your cardiologist and your neurologist talk to one another to make sure that their treatments are both neuroprotective and cardioprotective to the maximum extent possible.

 

[Cint]

There hasn't been enough research to be conclusive, but it seems pretty likely that there would be some sort of causal connection, with a long-term seizure history playing at minimum a contributing role.

onder: I think there HAS been enough research to come to the conclusion that there is a connection between E and heart failure, especially for someone like myself who has suffered from CPs and TCs for a long time. Plus congestive heart failure runs in my family.


Keep reading:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728482/

Seizure-Related Cardiac Abnormalities
In adults and children, most complex partial and generalized tonic–clonic seizures cause an increase in heart rate. Blumhardt et al. reported that 92% of 26 patients with temporal lobe seizures recorded by ambulatory EEG–EKG monitoring were associated with a dominant increase in heart rate. Subsequently, Smith and colleagues found that the most common pattern of heart rate change associated with complex partial seizures is that of an initial steep acceleration at the onset of the seizure, followed by marked variations during the seizure and postictally. This increase in heart rate was seen not only in the majority of clinically symptomatic seizures, but also in most subclinical seizures as well. The investigators also observed that the patterns of heart rate changes during and after the seizure were markedly similar amongst seizures within the same patient, suggesting that the same type of autonomic stimulation occurred in a stereotyped progression in those individuals. Keilson et al. reported that 93% of 106 lateralized and generalized seizures (in 45 patients who underwent 24-hour ambulatory EEG–EKG monitoring), of at least a 30-second duration, were associated with an ictal tachycardia of greater than 100 beats per minute. The investigators found that the ictal tachycardia did not favor one hemisphere over the other.

 

[Nakamova]

I agree, there is absolutely, positively no question that there is stress on the heart during all kinds of seizures, but researchers (who are notoriously conservative) haven't pointed to a straight-line causal connection between a long-term history of seizures and progressive heart damage. It makes total sense, and is a very likely conclusion, but because there are other factors (such as meds and genetics) in the mix, they can't say conclusively that x causes y.

 

[Porkette]

Hi Cint,
Thank you for the wonderful websites I appreciate it a lot and they have been very helpful. My neuro told me that my problem is called "periventricular nodular heterotopia (PNH) which has recently been associated with a heart abnormality known as aortic root dilation which can be life threatening.
Thanks again and May God Bless You!
Sue

 

[Porkette]

Hi Nakamova,
Thank you for the info. you sent me I really appreciate it. I've been taking Mysoline for over 30 yrs. and I wonder if this is what's caused some of the problem but I know once I go off the drug the seizures start up like crazy. I also took Tegretol for a few yrs. but I went off of that awhile back after I became allergic to the drug. I will just have to see a heart specialist and have a echocardiogram done to get more detail. Thanks again for your help and support. May God Bless You!

Sue