Postictal Serotonin Levels Associated With Periictal Apnea

Seizure-related increases in serum serotonin (5-HT) levels are associated with a reduced incidence of seizure-related breathing dysfunction, according to a study published online in Neurology.

Arun Murugesan, from Case Western Reserve University in Cleveland, and colleagues prospectively assessed video electroencephalography, plethysmography, capillary oxygen saturation, and electrocardiography for 49 patients enrolled in a study of sudden unexpected death in epilepsy. Serum 5-HT levels were measured in postictal and interictal venous blood samples. Data were included for 49 seizures with and without ictal central apnea (ICA) and 27 generalized convulsive seizures (GCS) with and without postconvulsive central apnea (PCCA).

The researchers found that for seizures without ICA, postictal serum 5-HT levels were increased over interictal levels compared with seizures with ICA. Serum 5-HT levels were increased postictally compared with interictal levels in patients with GCS without PCCA, but not in patients with seizures with PCCA. For the groups with and without PCCA, postictal minus interictal 5-HT levels also differed. After seizures without PCCA, increased heart rate was accompanied by increased serum 5-HT levels compared with those with PCCA.

"Our findings show that higher levels of serotonin after a seizure are associated with less breathing dysfunction, and while we cannot make any links between serotonin levels and a risk of sudden unexplained death in epilepsy, our research may provide some important clues," a coauthor said in a statement.

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