Seizure-triggered Takotsubo syndrome rarely causes SUDEP

Highlights

• Seizure-triggered Takotsubo syndrome (TTS) in adults occurs at all ages.

• There is a striking female preponderance to seizure-triggered TTS.

• All types of TTS may be triggered by seizures but the classical type prevails.

• Outcome of seizure-triggered TTS is usually favorable even without treatment.

• Pathogenetic implications of seizure-triggered TTS for SUDEP seem to be low.

Abstract

Since almost 20 y it is known that seizures may trigger Takotsubo syndrome (TTS). Since then it has been repeatedly proposed that TTS could be the cause of sudden unexpected death in epilepsy (SUDEP).

A review of the so far reported cases of seizure-triggered TTS was carried out to see how often seizure-triggered TTS is fatal.

Altogether 59 papers were identified which reported altogether 74 patients with seizure-triggered TTS. Age was reported in 70 patients and ranged from 18 to 82 y. Gender was reported in 70 cases and was female in 60 cases (86%). The type of triggering seizure was reported in 47 cases. In 28 patients (60%) the trigger was a generalized tonic clonic seizure, in 15 cases (32%) a generalized status epilepticus, and in 3 cases a complex partial seizure. The outcome was mentioned in 63 of the 74 patients. Full recovery was reported in 61 cases (97%), incomplete recovery in none of the patients, and a fatal outcome in 2 patients (3%).

Fatalities are rare in patients experiencing seizure-triggered TTS. This is why seizure-triggered TTS does not seem to play a major role in the pathogenesis of SUDEP.