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Serum serotonin levels in patients with epileptic seizures.

  • Author(s): Murugesan, Arun
  • Rani, MR Sandhya
  • Hampson, Johnson
  • Zonjy, Bilal
  • Lacuey, Nuria
  • Faingold, Carl L
  • Friedman, Daniel
  • Devinsky, Orrin
  • Sainju, Rup K
  • Schuele, Stephan
  • Diehl, Beate
  • Nei, Maromi
  • Harper, Ronald M
  • Bateman, Lisa M
  • Richerson, George
  • Lhatoo, Samden D
  • et al.

Published Web Location

Profound cardiovascular and/or respiratory dysfunction is part of the terminal cascade in sudden unexpected death in epilepsy (SUDEP). Central control of ventilation is mediated by brainstem rhythm generators, which are influenced by a variety of inputs, many of which use the modulatory neurotransmitter serotonin to mediate important inputs for breathing. The aim of this study was to investigate epileptic seizure-induced changes in serum serotonin levels and whether there are potential implications for SUDEP. Forty-one epileptic patients were pooled into 2 groups based on seizure type as (1) generalized tonic-clonic seizures (GTCS) of genetic generalized epilepsy and focal to bilateral tonic-clonic seizures (FBTCS; n = 19) and (2) focal seizures (n = 26) based on clinical signs using surface video-electroencephalography. Postictal serotonin levels were statistically significantly higher after GTCS and FBTCS compared to interictal levels (P = .002) but not focal seizures (P = .941). The change in serotonin (postictal-interictal) was inversely associated with a shorter duration of tonic phase of generalized seizures. The interictal serotonin level was inversely associated with a shorter period of postictal generalized electroencephalographic suppression. These data suggest that peripheral serum serotonin levels may play a role in seizure features and earlier postseizure recovery; these findings merit further study.

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