Abstracts

Sudden unexpected death in epilepsy (SUDEP) is an important cause of death among patients who are candidates for epilepsy surgery. As pathologic changes indicative of myocardial injury have been reported in association with SUDEP, the aim of our study was to measure cardiac troponin levels (cTnI), a very specific marker of myocardial damage, in patients with poor seizure control after epilepsy surgery. We prospectively investigated 12 patients with poor seizure control at least 2 years after epilepsy surgery admitted to the Epilepsy Unit at Brigadeiro Hospital, Brazil. Exclusion criteria included age younger than 18 years, history of cardiac illness and seizures types other than complex partial or secondarily tonic-clonic seizures. For each patient, a venous blood sample was obtained and the levels of cTnI were measured by immunometric assay (Immullite, Diagnostic Products Coorporation, LA, USA). Patients were categorized into one of three groups according to the level of cTn1: normal (lower than 0.10 ng/ml), low positive (0.10- 0.39 ng/ml) and high positive (0.40 ng/ml or higher) Mean age was 37 years (range, 21 to 64). TnI levels were normal in 10 and low-positive in one (0,16 ng/ml), which might eventually be included within the normal range. This patient had the higher post-operative seizure frequency within this series. Our results did not indicate an increased prevalence of high TnI levels in refractory epilepsy patients not cured by surgery. TnI levels might not be a good marker for increased SUDEP tendency in this selected population. (Supported by FAEP, FAPESP, CNPq and CAPES.)