Cardiac Comorbidity in Epilepsy: A Bibliographic Review

Abstract

Epilepsy is a disease characterized by recurrent epileptic seizures due to abnormal or excessive neuronal activity in the brain. It has been shown that these crises are associated with an increase in cardiac comorbidity. First, a relationship between epilepsy and cardiac arrhythmias has been shown, the most prevalent being sinus tachycardia. However, other entities like AV blocks or even asystole has been associated. Various mechanisms have been studied as the cause of these arrhythmias, among which, alterations at the level of ion channels stand out, which in many cases are associated with genetic alterations that cause channels that are found both in the brain and heart. Another aspect that has been evidenced is the presence of structural changes, as well as by molecular changes at the cardiac level. Regarding structural changes, echocardiographic findings of systolic and diastolic dysfunction have been evidenced, in addition to the presence in some cases of ventricular hypertrophy. Another aspect that has been found is the association of epilepsy with an increased prevalence of cardiovascular risk factors such as dyslipidemia or obesity, which is associated with the change in lifestyle that these patients have due to their diagnosis, however, despite this, it has not been possible to show a statistically significant increase in cardiovascular mortality. Finally, various medications used for epilepsy have been observed to increase cardiovascular risk; however, it has been observed that the risk due to an increase in seizures is greater than the theoretical risk that exists due to epilepsy drugs.