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Epilepsia. 2018 Jun;59(6):e91-e97. doi: 10.1111/epi.14198. Epub 2018 May 17.

Serum serotonin levels in patients with epileptic seizures.

Author information

1
Department of Neurology, Case Western Reserve University, Cleveland, OH, USA.
2
Center for SUDEP Research, National Institute for Neurological Disorders and Stroke, Cleveland, OH, USA.
3
Neurological Institute, University Hospitals, Cleveland, OH, USA.
4
Department of Pharmacology and Neurology, Southern Illinois University School of Medicine, Springfield, IL, USA.
5
Department of Neurology, New York University School of Medicine, New York, NY, USA.
6
Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
7
Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
8
Institute of Neurology, University College London, London, UK.
9
Department of Neurology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
10
Department of Neurobiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
11
Department of Neurology, Columbia University Medical Center, New York, NY, USA.

Abstract

Profound cardiovascular and/or respiratory dysfunction is part of the terminal cascade in sudden unexpected death in epilepsy (SUDEP). Central control of ventilation is mediated by brainstem rhythm generators, which are influenced by a variety of inputs, many of which use the modulatory neurotransmitter serotonin to mediate important inputs for breathing. The aim of this study was to investigate epileptic seizure-induced changes in serum serotonin levels and whether there are potential implications for SUDEP. Forty-one epileptic patients were pooled into 2 groups based on seizure type as (1) generalized tonic-clonic seizures (GTCS) of genetic generalized epilepsy and focal to bilateral tonic-clonic seizures (FBTCS; n = 19) and (2) focal seizures (n = 26) based on clinical signs using surface video-electroencephalography. Postictal serotonin levels were statistically significantly higher after GTCS and FBTCS compared to interictal levels (P = .002) but not focal seizures (P = .941). The change in serotonin (postictal-interictal) was inversely associated with a shorter duration of tonic phase of generalized seizures. The interictal serotonin level was inversely associated with a shorter period of postictal generalized electroencephalographic suppression. These data suggest that peripheral serum serotonin levels may play a role in seizure features and earlier postseizure recovery; these findings merit further study.

KEYWORDS:

focal; generalized; postictal EEG suppression; sudden unexpected death in epilepsy; tonic

PMID:
29771456
PMCID:
PMC6141199
[Available on 2019-06-01]
DOI:
10.1111/epi.14198
[Indexed for MEDLINE]
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