Epilepsy and sudden unexpected death in epilepsy?: eat more fish! A group hypothesis.

Programa de Pós-Graduação em Distúrbios do Desenvolvimento, Centro de Ciências Biológicas e da Saúde, Universidade Presbiteriana Mackenzie, São Paulo, SP, Brasil.
Arquivos de neuro-psiquiatria (Impact Factor: 1.01). 09/2009; 67(3B):927-9. DOI: 10.1590/S0004-282X2009000500032
Source: PubMed

ABSTRACT Epilepsy is the commonest serious neurological disorder and individuals with epilepsy are at higher risk of death than the general population and sudden unexpected death in epilepsy (SUDEP) is the most important direct epilepsy-related cause of death. Potential pathomechanisms for SUDEP are unknown, but it is very probable that cardiac arrhythmias during and between seizures play a potential role. The ultimate goal of SUDEP research is to develop methods to prevent it and nutritional aspects such as omega-3 fatty acid deficiency may have an interesting role in this scenario. Omega-3 fatty acids reduce the risk of cardiovascular mortality and are important for treating or preventing some neurological diseases, including epilepsy. A dietary modification or nutritional supplements increasing the ingestion of omega-3 fatty acids may help to ''save the brain'.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A large body of published data was analyzed to determine the concentrations of DHA, vitamins B12 and D, iodine, selenium in seafood (finfish and shellfish, wild and farmed, seawater and freshwater). The data on apparent consumption per inhabitant were taken from statistics prepared by OFIMER. This was used to determine the mean consumption of the main products of seafood in France in 2004 and the mean intakes of people aged 65 years and over. Not enough seafood is consumed by older people, according to the French recommended dietary allowances (french RDA), seafood provides 25% of the vitamin D RDA, 56% of the vitamin B12 RDA, 28% of iodine RDA, 23% of selenium RDA and 203% of DHA french RDA. For DHA, mean intake is aprox. 100% of international RDA. Seafood is the only class of food that provides major fractions of all these elements. We therefore recommend that older people increase their consumption of seafood to counteract the potential problems due to the low concentrations of these elements in their usual diets; this could overcome a potentially major public health problem. All elderly people would benefit from an increased intake of vitamin D and B12, iodine and selenium. Although some segments of the population seem not to lack DHA, others, such as those whose socio-economic positions or life styles restrict their seafood intakes, would benefit greatly from an increased intake of this omega-3 polyunsaturated fatty acid.
    The Journal of Nutrition Health and Aging 04/2008; 12(3):186-92. DOI:10.1007/BF02982617
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Although largely neglected in earlier literature, sudden unexpected death in epilepsy (SUDEP) is the most important epilepsy-related mode of death, and is the leading cause of death in people with chronic uncontrolled epilepsy. Research during the past two to three decades has shown that incidence varies substantially depending on the epilepsy population studied, ranging from 0.09 per 1000 patient-years in newly diagnosed patients to 9 per 1000 patient-years in candidates for epilepsy surgery. Risk profiles have been delineated in case-control studies. These and other studies indicate that SUDEP mainly occurs in the context of a generalised tonic-clonic seizure. However, it remains unclear why a seizure becomes fatal in a person that might have had many similar seizures in the past. Here, we review SUDEP rates, risk factors, triggers, and proposed mechanisms, and critically assess potential preventive strategies. Gaps in knowledge are discussed and ways forward are suggested.
    The Lancet Neurology 10/2008; 7(11):1021-31. DOI:10.1016/S1474-4422(08)70202-3