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Letters In Reply We appreciate the interest and comments of Palma et al prevent death), but we may be able to classify potential risk regardingourrecentreviewabouttheonsetofsynucleinopathies. factors or determine the pathophysiological mechanisms that Thereviewwasbasedonepidemiologicalevidence.Notably,there are responsible for SUDEP. have not been sufficient epidemiologic data that examine some Regarding administering preventive measures properly, ω-3 of the early manifestations or symptoms for some aspects of fatty acid supplementation for individuals with epilepsy is still synucleinopathies. As an example, the prospective study per- neglected by epileptologists. Why? For more than a decade, a formed by the Autonomic Disorders Consortium on the natural possible neuroprotective and cardioprotective role of ω-3 fatty 2 3 history of pure autonomic failure was based on 100 patients. acids has been demonstrated. Briefly, translational studies have Although the sample size is large for a pure autonomic failure demonstrated that supplementation with ω-3 fatty acids may study, it is a relatively small number when compared with larger reduce seizures and seizure-associated cardiac arrhythmias, 3,4 population-basedepidemiologycohorts.Likewise,orthostatichy- and as a result SUDEP. Even so, why not prescribe ω-3 fatty potension is one of the most important signs of dysautonomia in acids to patients? Is there a need for more randomized clinical synucleinopathies.
JAMA Neurology – American Medical Association
Published: Sep 13, 2018
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