Respiratory Mechanics and Diaphragm Function in Patients with Epilepsy: A Current Review from a Neurological and Physiological Perspective

Beyond its hallmark seizures, epilepsy can profoundly impact the respiratory system. Recent investigations have uncovered marked impairments in respiratory mechanics, with particular deterioration in diaphragmatic function among affected individuals. Peri-ictal and postictal events such as apnea, hypoventilation, and irregular breathing patterns constitute primary contributors to the heightened risk of sudden unexpected death in epilepsy (SUDEP). Neuromodulatory influences originating in regions like the brainstem and amygdala can induce transient or sustained suppression of respiratory centers. Diminished diaphragmatic performance, in turn, predisposes patients to serious complications including hypoxia and hypercarbia. Furthermore, certain antiseizure medications are recognized for their potential respiratory depressant properties. Assessment of respiratory status employs techniques including pulmonary function testing, diaphragmatic ultrasonography, and polysomnography. In respiratory rehabilitation, exercises aimed at strengthening the diaphragm and improving breath control are vital for complication prevention. Epilepsy management should embrace a multidisciplinary framework, ensuring early identification and intervention for respiratory dysfunction. Continued research in this field remains essential for reducing SUDEP risk and advancing the quality of patient care.