癫痫猝死(SUDEP)指貌似健康的癫痫患者在强直-阵挛性发作期间或发作后的突然死亡。癫痫患者发生猝死的风险是普通人群的20多倍,癫痫发作持续时间及严重程度决定SUDEP发生率。SUDEP可能存在多种发病机制,目前研究主要集中于发作相关的心律失常、呼吸或大脑活动抑制和自主神经功能障碍。尽管大多数癫痫发作在短时间内对心脏无损伤作用,但心源性因素在SUDEP中可能发挥着关键作用。明确SUDEP发生的心脏相关机制可能为该病的防治提供有效策略。
Summary Sudden unexpected death in epilepsy (SUDEP) indicates sudden death without a clear cause in an individual with epilepsy,especially during or immediately after a tonic-clonic seizure. Overall, the risk of sudden death in person with epilepsy is over 20 times higher than that in general population. In addition, the incidence of SUDEP depends on the duration and severity of seizures. The explicit pathogenesis is still dimness, however the seizure related arrhythmias, respiratory or cerebral depression and autonomic dysfunction may be mainly associated with SUDEP. Although most seizures could not induces the damage of the heart in a short time, cardiac factors are likely to play a pivotal role in SUDEP. Understanding of the mechanisms about the cardiac factors is required to provide the orientation for the establishment of future control strategy of SUDEP.