TY - JOUR
T1 - Hypertension, seizures, and epilepsy
T2 - a review on pathophysiology and management
AU - On behalf of the Epilepsy Study Group of the Italian Neurological Society
AU - Gasparini, Sara
AU - Ferlazzo, Edoardo
AU - Sueri, Chiara
AU - Cianci, Vittoria
AU - Ascoli, Michele
AU - Cavalli, Salvatore M.
AU - Beghi, Ettore
AU - Belcastro, Vincenzo
AU - Bianchi, Amedeo
AU - Benna, Paolo
AU - Cantello, Roberto
AU - Consoli, Domenico
AU - De Falco, Fabrizio A.
AU - Di Gennaro, Giancarlo
AU - Gambardella, Antonio
AU - Gigli, Gian Luigi
AU - Iudice, Alfonso
AU - Labate, Angelo
AU - Michelucci, Roberto
AU - Paciaroni, Maurizio
AU - Palumbo, Pasquale
AU - Primavera, Alberto
AU - Sartucci, Ferdinando
AU - Striano, Pasquale
AU - Villani, Flavio
AU - Russo, Emilio
AU - De Sarro, Giovambattista
AU - Aguglia, Umberto
N1 - Publisher Copyright:
© 2019, Fondazione Società Italiana di Neurologia.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Background: Epilepsy and hypertension are common chronic conditions, both showing high prevalence in older age groups. This review outlines current experimental and clinical evidence on both direct and indirect role of hypertension in epileptogenesis and discusses the principles of drug treatment in patients with hypertension and epilepsy. Methods: We selected English-written articles on epilepsy, hypertension, stroke, and cerebrovascular disease until December, 2018. Results: Renin-angiotensin system might play a central role in the direct interaction between hypertension and epilepsy, but other mechanisms may be contemplated. Large-artery stroke, small vessel disease and posterior reversible leukoencephalopathy syndrome are hypertension-related brain lesions able to determine epilepsy by indirect mechanisms. The role of hypertension as an independent risk factor for post-stroke epilepsy has not been demonstrated. The role of hypertension-related small vessel disease in adult-onset epilepsy has been demonstrated. Posterior reversible encephalopathy syndrome is an acute condition, often caused by a hypertensive crisis, associated with the occurrence of acute symptomatic seizures. Chronic antiepileptic treatment should consider the risk of drug-drug interactions with antihypertensives. Conclusions: Current evidence from preclinical and clinical studies supports the vision that hypertension may be a cause of seizures and epilepsy through direct or indirect mechanisms. In both post-stroke epilepsy and small vessel disease-associated epilepsy, chronic antiepileptic treatment is recommended. In posterior reversible encephalopathy syndrome blood pressure must be rapidly lowered and prompt antiepileptic treatment should be initiated.
AB - Background: Epilepsy and hypertension are common chronic conditions, both showing high prevalence in older age groups. This review outlines current experimental and clinical evidence on both direct and indirect role of hypertension in epileptogenesis and discusses the principles of drug treatment in patients with hypertension and epilepsy. Methods: We selected English-written articles on epilepsy, hypertension, stroke, and cerebrovascular disease until December, 2018. Results: Renin-angiotensin system might play a central role in the direct interaction between hypertension and epilepsy, but other mechanisms may be contemplated. Large-artery stroke, small vessel disease and posterior reversible leukoencephalopathy syndrome are hypertension-related brain lesions able to determine epilepsy by indirect mechanisms. The role of hypertension as an independent risk factor for post-stroke epilepsy has not been demonstrated. The role of hypertension-related small vessel disease in adult-onset epilepsy has been demonstrated. Posterior reversible encephalopathy syndrome is an acute condition, often caused by a hypertensive crisis, associated with the occurrence of acute symptomatic seizures. Chronic antiepileptic treatment should consider the risk of drug-drug interactions with antihypertensives. Conclusions: Current evidence from preclinical and clinical studies supports the vision that hypertension may be a cause of seizures and epilepsy through direct or indirect mechanisms. In both post-stroke epilepsy and small vessel disease-associated epilepsy, chronic antiepileptic treatment is recommended. In posterior reversible encephalopathy syndrome blood pressure must be rapidly lowered and prompt antiepileptic treatment should be initiated.
KW - Epilepsy
KW - Hypertension
KW - Posterior reversible encephalopathy syndrome
KW - Seizures
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=85065430452&partnerID=8YFLogxK
U2 - 10.1007/s10072-019-03913-4
DO - 10.1007/s10072-019-03913-4
M3 - Review article
SN - 1590-1874
VL - 40
SP - 1775
EP - 1783
JO - Neurological Sciences
JF - Neurological Sciences
IS - 9
ER -