Sudden withdrawal of carbamazepine increases cardiac sympathetic activity in sleep

@article{Hennessy2001SuddenWO,
  title={Sudden withdrawal of carbamazepine increases cardiac sympathetic activity in sleep},
  author={Michael J. Hennessy and Mary Tighe and C. D. Binnie and Lina Nashef},
  journal={Neurology},
  year={2001},
  volume={57},
  pages={1650 - 1654}
}
Objective: To evaluate the cardiac autonomic effects of abrupt withdrawal of carbamazepine (CBZ) during sleep in patients with epilepsy. Background: The pathophysiology of sudden unexpected death in epilepsy (SUDEP) is uncertain, with ictal or peri-ictal cardiorespiratory compromise appearing probable. Risk factors for SUDEP include multiple antiepileptic drugs (AED), poor compliance, and abrupt AED withdrawal. The spectral analysis of the beat-to-beat heart rate variability (HRV) displays two… 

Tables from this paper

Changes in autonomic cardiac control in patients with epilepsy after discontinuation of antiepileptic drugs: a randomized controlled withdrawal study

The results demonstrate that slow withdrawal of AEDs in seizure‐free patients with epilepsy on drug mono‐therapy resulted in an increase in both parasympathetic and sympathetic functions, indicative of increased power amongst patients following cessation of Aed treatment.

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The results indicate that there is an impaired autonomic cardiac control, reflected in decreased HRV, preferentially among the type of epilepsy patients that have been considered to have a higher risk of SUDEP.

Lack of heart rate variability during sleep-related apnea in patients with temporal lobe epilepsy (TLE)—an indirect marker of SUDEP?

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Sudden unexpected death in epilepsy: risk factors and potential pathomechanisms

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