Comparison of heart rate variability among children with well controlled versus refractory epilepsy: A cross-sectional study (original) (raw)

Heart rate variability in children with refractory generalized epilepsy

Seizure, 2008

Repetitive seizures can alter the regulation of cardiac activity by the autonomic nervous system (ANS), and ANS dysregulation is thought to be associated with higher morbidity and mortality in epileptic patients, especially from sudden unexpected death. Few studies of interictal dysregulation of cardiac activity in children with epilepsy have been performed. In this study we characterize heart rate variability (HRV) in children with refractory generalized epilepsy. Fifteen male and 15 female children, average age = 10.9+/-0.6 years, all with refractory generalized epilepsy were enrolled into the study group. A control group consisted of 15 males and 15 females with average age = 10.6+/-0.6 years. A lead I ECG was recorded for 5 min in the interictal period during daylight hours from each subject while awake. Frequency-domain analysis of HRV was performed using a non-parametric method of fast Fourier transformation. Changes of HRV were categorized into high frequency power (HF; 0.15-...

CARDIAC AUTONOMIC DYSFUNCTION IN PATIENTS WITH EPILEPSY

International Journal of Pharmacy and Pharmaceutical Sciences, 2023

Objective: The objective of this research was to appraise autonomic impairment through the examination of both time-domain and frequencydomain parameters of heart rate variability in individuals with epilepsy. Methods: Thirty epilepsy patients and thirty healthy subjects were enrolled in our study for evaluation of autonomic functions, which was assessed by comparing heart rate variability between epilepsy patients and healthy subjects. Results: There was no notable disparity observed in mean heart rate between the two groups. However, the frequency-domain metrics-LF Power, HF Power, and LF/HF ratio exhibited statistically noteworthy differences when comparing the patients to the control group (p-value<0.05). Conversely, parameters such as SDNN, RMSST, and pNN50 did not demonstrate statistically considerable differences in comparison to the controls (p-value>0.05). The parameters did not exhibit statistically significant distinctions between individuals with epilepsy for under 10 y and those diagnosed with epilepsy for over 10 y. Conclusion: Our investigation revealed a notable contrast in HRV metrics between the patient group and the group of individuals in good h ealth. The potential utilization of HRV as an indicator of susceptibility to SUDEP could enhance the quality of guidance provided to both patients and their families. Additional exploration is warranted, involving more extensive participant cohorts, and examining the impact of anti epileptic medications on HRV, within future studies.

Retrospective analysis of autonomic dysfunction in epilepsy patients from neurophysiological recordings

Neurology Asia

Autonomic dysfunction is often associated with seizures in patients with epilepsy. Autonomic dysfunction during seizures can cause serious events like cardiac arrest and sudden unexplained death. Early detection of autonomic dysfunction is crucial to avoid such medical emergencies. In our study, we analyzed the heart rate variability (HRV) in physiological recording during the preictal, ictal and postictal periods. A total of 142 seizures with various semiologies recorded from 49 epilepsy patients were included. Time-domain measurements including mean hear rate (HR), RR interval (RRI), root-mean-square of successive R-R interval differences (RMSSD), The standard deviation of N-N intervals (SDNN) and percentage of successive RR intervals that differ by more than 50 ms(pNN50) were analyzed at different time points, 20 minutes before the seizure, 1 minute before the seizure, during the seizure and 20 minutes after the seizure. We observed there was a significant difference in HRV param...

Study of cardiac autonomic function in drug-naïve, newly diagnosed epilepsy patients

Epileptic disorders : international epilepsy journal with videotape, 2010

Epilepsy is associated with ictal autonomic dysfunction which may extend into the inter-ictal period. Antiepileptic drugs have often been blamed for cardiac autonomic dysfunction in epilepsy patients. In this study we have investigated cardiac autonomic parameters in order to evaluate autonomic functions of drug-naïve epilepsy patients. Twenty drug-naïve patients (15 males and 5 females) with epilepsy, and an equal number of age and gender matched controls, were evaluated for short-term resting heart rate variability and conventional cardiovascular autonomic measurements. The mean age of patients was 29.30 +/- 9.80 yrs (17-55 yrs), mean age at seizure onset was 19.70 +/- 9.15 yrs (3-40 yrs) and mean length of time since last seizure was 5.60 +/- 7.00 days (1-30 days). While there was no difference in the resting heart rate or conventional autonomic test parameters, time domain heart rate variability measurements showed a decreased percentage of R-R intervals of less than 50 ms and r...

A systematic review and meta-analysis of heart rate variability in epilepsy and antiepileptic drugs

Epilepsia, 2012

Purpose: Epilepsy is associated with near-fatal and fatal arrhythmias, and sudden unexpected death in epilepsy (SUDEP) is partly related to cardiac events. Dysfunction of the autonomous nervous system causes arrhythmias and, although previous studies have investigated the effects of epilepsy on the autonomic control of the heart, the results are still mixed regarding whether imbalance of sympathetic, vagal, or both systems is present in epilepsy, and also the importance of anticonvulsant treatment on the autonomic system. Therefore, we aimed to investigate epilepsy and its treatment impact on heart rate variability (HRV), assessed by sympathetic and parasympathetic activity expressed as low-frequency (LF) and high-frequency (HF) power spectrum, respectively. Method: We performed a systematic review from the first date available to July 2011 in Medline and other databases; key search terms were ''epilepsy''; ''anticonvulsants''; ''heart rate variability''; ''vagal''; and ''autonomous nervous system.'' Original studies that reported data and/or statistics of at least one HRV value were included, with data being extracted by two independent authors. We used a random-effects model with Hedges's g as the measurement of effect size to perform two main meta-analyses comparing LF and HF HRV values in (1) epilepsy patients versus controls; (2) patients receiving versus not receiving treatment; and (3) well-controlled versus refractory patients. Secondary analyses assessed other time-and frequency-domain measurements (nonlinear methods were not analyzed due to lack of sufficient data sets). Quality assessment of each study was verified and also meta-analytic techniques to identify and control bias. Meta-regression for age and gender was performed.

Electrophysiologic assessment of autonomic function in epilepsy

Seizure-european Journal of Epilepsy, 1998

Sudden unexpected death associated with epilepsy (SUDEP) is an important clinical problem. Peri-ictal autonomic dysfunction is thought to play a role in SUDEP and few means exist for clinical identification of patients at risk.