Sudden unexpected death in children with epilepsy: the many faces of fungal pathogenicity

Abstract

Epilepsy is one of the most prevalent neurological diseases worldwide. The mortality rates are considerably higher in people with epilepsy than would be expected in a healthy population and sudden unexpected death in epilepsy (SUDEP) is the most frequent epilepsy-related category of death. Most children had seizures before the occurrence of the fatal event and autonomic dysfunction has been proposed as mechanisms of sudden death in this population. Is this sense, we raise the question whether is there a possible relationship between SUDEP in children and fungal pathogenicity. Indeed, the role of fungal pathogenicity in the establishment of epilepsy and even in cases of SUDEP has an interesting role in this scenario. Moreover, maternal infections during pregnancy have been associated with an increased risk for several brain disorders, however, this fact is still considered uncertain with respect to epilepsy. Based on this information and considering that maternal-fetal yeast infection is directly associated with an increased risk for epilepsy in childhood and that some patients have medically intractable epilepsy, the chances of these children suffering a fatal event cannot be overlooked by healthcare professionals. Thus, as exact knowledge regarding this association is lacking, some possibilities could be evaluated, and more emphasis on translational research would contribute to further progress to the knowledge of SUDEP.