Seizures in amygdala could lead to sudden unexpected death in epilepsy
A research team supported by the National Institutes of Health (NIH) has identified a part of the brain that may be associated with breathing failure following a seizure in people with severe epilepsy that cannot be controlled with medication. This condition, known as sudden unexpected death in epilepsy (SUDEP), is the leading cause of death in this patient population. Most cases of SUDEP are thought to be due to postictal apnea, a loss of breathing that occurs after a seizure ends. The study found that individuals who experience postictal apnea lose the urge to breathe, suggesting that the brain may not detect rising carbon dioxide levels in the blood during apnea. The research involved enrolling 12 adults and eight children with uncontrolled epilepsy and using intracranial electroencephalography to induce seizures and examine the brain’s control of breathing. Seizures originating in the amygdala, a brain region associated with emotion and fear, were found to cause postictal apnea. Novel connections between the amygdala and brainstem regions critical for sensing changes in blood CO2 levels and controlling breathing were also identified. Further studies are needed to confirm the role of the amygdala in breathing suppression and its connection to SUDEP.