Acid reflux induced laryngospasm as a potential mechanism of sudden death in epilepsy.
Acid reflux induced laryngospasm as a potential mechanism of sudden death in epilepsy.
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DOI：
10.1016/j.eplepsyres.2018.10.003
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发表时间：
2018-12
影响因子：
2.2
通讯作者：
Irazoqui PP
中科院分区：
文献类型：
--
作者：
Budde RB;Arafat MA;Pederson DJ;Lovick TA;Jefferys JGR;Irazoqui PP
最近的研究表明，阻塞性喉痉挛和随之而来的呼吸停止可能是癫痫猝死的一种机制。我们试图检验一个新的假设，即喉痉挛是由癫痫发作导致胃酸回流到喉，而不是喉返神经的自发病理活动。我们使用急性海人酸模型乌拉坦麻醉下观察癫痫发作活动在Long-Evans大鼠。我们测量了食道的pH值和呼吸活动。在一组实验中，我们用气囊导管阻断了酸在食管中的移动。在所有猝死病例中，终末呼吸暂停之前，食管中的pH值从7大幅下降至2。在几种动物中，我们观察到酸性液体流出口腔，有时数量很大。在酸运动受阻的动物中，没有发生猝死。对照组中未检出酸。结果表明，酸运动食管是一个触发器在KA诱发癫痫猝死。阻断胃酸也能消除猝死，这一事实暗示了因果关系。这些结果可能为人类SUDEP的机制提供了新的见解。
Recent research suggests that obstructive laryngospasm and consequent respiratory arrest may be a mechanism in sudden unexpected death in epilepsy. We sought to test a new hypothesis that this laryngospasm is caused by seizures driving reflux of stomach acid into the larynx, rather than spontaneous pathological activity in the recurrent laryngeal nerve. We used an acute kainic acid model under urethane anesthesia to observe seizure activity in Long-Evans rats. We measured the pH in the esophagus and respiratory activity. In a subset of experiments, we blocked acid movement up the esophagus with a balloon catheter. In all cases of sudden death, terminal apnea was preceded by a large pH drop from 7 to 2 in the esophagus. In several animals we observed acidic fluid exiting the mouth, sometimes in large quantities. In animals where acid movement was blocked, sudden deaths did not occur. No acid was detected in controls. The results suggest that acid movement up the esophagus is a trigger for sudden death in KA induced seizures. The fact that blocking acid also eliminates sudden death implies causation. These results may provide insight to the mechanism of SUDEP in humans.
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影响因子：
19.6
作者：
CAFLISCH, CR;PUCACCO, LR;CARTER, NW
通讯作者：
CARTER, NW
影响因子：
3.7
作者：
Horn CC;Kimball BA;Wang H;Kaus J;Dienel S;Nagy A;Gathright GR;Yates BJ;Andrews PL
通讯作者：
Andrews PL
DOI：
10.1007/bf01617716
发表时间：
1995-05-01
期刊：
JOURNAL OF CLINICAL MONITORING
影响因子：
--
作者：
MARKS, MK;SOUTH, M;CARTER, BG
通讯作者：
CARTER, BG
DOI：
10.1038/nrneurol.2014.64
发表时间：
2014-05
期刊：
Nature reviews. Neurology
影响因子：
--
作者：
Massey CA;Sowers LP;Dlouhy BJ;Richerson GB
通讯作者：
Richerson GB
影响因子：
5.4
作者：
Hassel, AW;Fushimi, K;Seo, M
通讯作者：
Seo, M