Literature Review

Air pollution is a seizure trigger for patients with epilepsy


 

Unclear mechanism

The exact mechanisms linking air pollution to seizures are unclear but probably involve the synergistic interaction of multiple pathways, said Mr. Chen. “Air pollution may affect brain metabolism, alter the immune response of the brain, and induce oxidative stress and neuroinflammation, causing the brain to be more susceptible to seizures,” he noted.

This is the first study to investigate seizure rates through intracranial EEG signals and self-reported seizure diaries. It’s also the first to look into the impact of pollutants at low concentration levels on subclinical seizures.

However, the study has some limitations. Self-reported seizures in the SD dataset might underestimate the influence of air pollution on seizures. The study used postal codes as proxies for exposure to pollution, which could introduce measurement errors and underestimate associations.

In addition, Mr. Chen noted that seizures from the NeuroVista dataset were recorded from patients with drug-resistant focal epilepsy. “Whether our findings can be generalized to other epilepsy types needs further investigation.”

The study could have important clinical and public health implications. For example, said Mr. Chen, it’s possible that seizure risk could be reduced through behavioral interventions, such as avoiding being outside or using an air filtration system when pollutant levels are high.

“Clinicians could counsel their patients to avoid the potential risk of high carbon monoxide exposure,” he said.

CO exposure could be a new factor for seizure risk forecasting, which could reduce the uncertainty of seizures and help guide epilepsy management, Mr. Chen added.

The study was supported by the Melbourne Monash Consciousness Research Seed Funding and an Australian National Health and Medical Research Council Ideas grant. Mr. Chen has disclosed no relevant financial relationships.

A version of this article first appeared on Medscape.com.

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