Sudden death from deep in the brain?

Risk of sudden unexpected death in epilepsy (SUDEP) is among comorbidities present in Dravet Syndrome (DS), a rare, catastrophic form of epilepsy in which seizures begin in infancy, with most cases due to mutations in a single gene, SCN1A.

Breathing issues have been reported in patients and in mouse models of DS, and a recent study implicated respiratory decline in SUDEP in DS mice.

In the journal eNeuro, William Nobis, MD, Ph.D., Wen Wei Yan, MD, Maya Xia and colleagues report experiments in DS mice showing altered excitability in a complex of neurons deep in the brain, the bed nucleus of the stria terminalis (BNST), and significant under-excitability of neurons projecting from the BNST to the parabrachial nucleus, which is located atop the brainstem and is involved in respiration.

Noting that this circuit might be driving respiratory dysfunction and sudden death in DS, the authors call for further study of the role of deep brain structures in epilepsy models.