PO18-WE-53 Effect of temporal lobe epilepsy surgery on cardiovascular autonomic functions (original) (raw)
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Journal of epilepsy research, 2017
Refractory temporal lobe epilepsy (TLE) is commonly associated with imbalances in cardiovascular (CV) parasympathetic and sympathetic functions, which are treated using TLE surgery. We investigated the effect of hemispheric lateralization of seizure foci on autonomic CV functions before and after TLE surgery. The study was conducted on patients with left TLE (LTLE, n = 23) and right TLE (RTLE, n = 30) undergoing unilateral TLE surgery. To assess the autonomic CV functions, changes in the heart rate (ΔHR) and blood pressure (BP) were measured using a standardized battery of autonomic reactivity tests before surgery and at 3 and 6 months after surgery. Before surgery, ΔHR and the expiration to inspiration ratio (E:I) during the deep breathing test were higher in the LTLE group than in the RTLE group (both p < 0.001), but both outcomes were comparable between the groups at 3 and 6 months. ΔHR decreased at 3 and 6 months (p < 0.001 and 0.01, respectively) compared with preoperativ...
Outcome of epilepsy surgery correlates with sympathetic modulation and neuroimaging of the heart
Journal of the Neurological Sciences, 2003
Temporal lobe epilepsy (TLE) is frequently associated with sympathetic over-activity. Single photon emission computed tomography (SPECT) with 123 iodine-meta-iodobenzylguanidine (MIBG), a norepinephrine analogue, showed reduced tracer uptake in cardiac sympathetic nerve endings, indicating myocardial catecholamine disturbance. We investigated whether outcome of epilepsy surgery correlates with cardiac autonomic function in TLE patients.
Interictal alterations of cardiovagal function in chronic epilepsy
Epilepsy Research, 2009
Aim: To assess the function of parasympathetic heart control in patients with epilepsy by means of clinical routine neurophysiology. Materials and methods: Seventy-one consecutive epileptic patients (mean age ± S.D. 37.8 ± 12.9 years) with partial or generalized seizures manifested for more than 6 months and receiving various therapeutic regimes and 71 matched for sex and age healthy controls undertook a battery of neurophysiological tests which consisted of sensory conduction of sural nerve; R-R interval variation during normal and deep breathing; Valsalva manoeuvre and tilt test for calculation heart rate changes to respiratory strain and standing. Results: The patient group showed a significant difference in all parasympathetic parameters studied compared to the control group. Overall, 42.2% of patients had abnormal measurement in at least one of the parameters and Valsalva was the most frequently abnormal one (31% of patients). Sural nerve amplitude was significantly lower in the patients than in the controls and its measurements were associated with those of the tilt test. Long epilepsy duration (more than 10 years) and treatment with phenytoin showed a negative effect on data of R-R interval variation during deep breathing. No other correlations between measurements of parasympathetic parameters and epilepsy related characteristics i.e. type and frequency of seizure, monotherapy or combined therapy with seven other antiepileptic medications, were proven. Conclusions: Our results suggested that simple neurophysiological tests, suitable for screening purposes were able to demonstrate suppressed cardiovagal control in epileptic patients and to identify those in need for further analysis of cardiovagal function.
Interictal cardiac autonomic dysfunction in temporal lobe epilepsy demonstrated by
2000
evaluated the effects of carbamazepine on cardiac sympathetic innervation. TLE is frequently associated with dysfunction of the autonomic nervous system. Autonomic dysregulation might contribute to unexplained sudden death in epilepsy. Anticonvulsive medication, particularly with carbamazepine, might also influence autonomic cardiovascular modulation. MIBG-SPECT allows the quantification of post-ganglionic cardiac sympathetic innervation, whereas measuring the variability of the heart rate provides only functional parameters of autonomic modulation. Antiepileptic drugs, especially carbamazepine (CBZ), can affect cardiovascular modulation. We determined the index of cardiac MIBG uptake (heart/mediastinum ratio) and heart rate variability (HRV) using time and frequency domain parameters of sympathetic and parasympathetic modulation in 12 women and 10 men (median age 34.5 years) with a history of TLE for 7-41 years (median Keywords: temporal lobe epilepsy; cardiac autonomic dysfunction; [ 123 I]MIBG-SPECT; heart rate variability Abbreviations: b.p.m. ϭ beats per minute; CBZ ϭ carbamazepine; CV ϭ coefficient of variation; HF ϭ high frequency; H/M ϭ heart/mediastinum ratio; HR ϭ heart rate; HRV ϭ heart rate variability; LF ϭ low frequency; MIBG-SPECT ϭ metaiodobenzylguanidine-single photon emission computed tomography; MSA ϭ multiple system atrophy; ROI ϭ region of interest; RMSSD ϭ root mean square of successive differences; TLE ϭ temporal lobe epilepsy
Seizure, 2013
There is evidence of autonomic dysregulation in temporal lobe epilepsy. The structures removed during temporal lobectomy are important centers of central cardiovascular control; therefore surgery may conceivably alter the cardiovascular autonomic function. The effects of temporal lobectomy on autonomic cardiac control are controversial. We investigated the effects of temporal lobectomy on heart rate variability (HRV) in the early and late postoperative periods. We used 1-h ECG recordings to assess heart rate variability by spectral analysis in 24 consecutive patients who underwent temporal lobectomy due to intractable temporal lobe epilepsy. ECG recordings were performed before and twice (early and late) after surgery. The results were compared with age and sex matched controls. When compared with controls, all the time and frequency domain indices (SDRR, RMSSD, TP, LF and HF) were significantly lower in the patient group before surgery. Findings were similar in the early and late p...
Epilepsy & Behavior, 2009
The aim of this study was to evaluate possible factors affecting interictal cardiovascular autonomic function in temporal lobe epilepsy with complex partial seizures, paying special attention to hippocampal sclerosis. The study was carried out with 88 patients with epilepsy (22 with left hippocampal sclerosis, 22 with right hippocampal sclerosis, and 44 without hippocampal sclerosis) and 44 healthy subjects. All subjects underwent three tests of cardiac autonomic function: heart rate variation during resting activity, heart rate variation in response to deep breathing and blood pressure response to rising quickly from the supine position. Hippocampal sclerosis and disease duration were found to have significantly important effects on parasympathetic autonomic function, whereas seizure control and type of antiepileptic drug had significant effects on sympathetic autonomic function. This study shows that in addition to factors related to the chronic nature of epilepsy and antiepileptic drug use, hippocampal sclerosis may cause autonomic dysfunction during the interictal period in persons with temporal lobe epilepsy.
Interictal autonomic dysfunction in patients with epilepsy
The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 2021
Background Autonomic nervous system (ANS) symptoms are frequently present in people with epilepsy (PwE). They are generally more prominent when they originate from the temporal lobe. We aim to investigate the alterations of autonomic functions during the interictal period in patient with temporal lobe epilepsy (TLE) and idiopathic generalized epilepsy (IGE) using heart-based tests, blood pressure (BP)-based tests and sympathetic skin response (SSR). Forty-eight PwE with disease duration ranging from 2 to 15 years and 51 healthy individuals were studied. Long-term electroencephalography (EEG) monitoring, the heart rate variability (HRV) during normal breathing, deep breathing, Valsalva maneuver and standing, BP responses during standing, to isometric hand grip and to mental arithmetic, and the SSR was recorded for all participants. Results 31 patients with TLE and 17 with IGE showed lower RR-IV values during deep breathing, Valsalva maneuver and standing, but not during rest, impaire...
Ictal ECG changes in temporal lobe epilepsy
Arquivos de Neuro-Psiquiatria, 1995
Changes in cardiac rhythm may occur during epileptic seizures and this has been suggested as a possible mechanism for sudden unexpected death amongst patients with chronic epilepsy (SUDEP). We have studied ECG changes during 61 complex partial seizures of temporal lobe origin in 20 patients. Tachycardia was observed in 24/61 (39%) and bradycardia in 3/61 (5%). The mean and median tachycardia rate was 139 and 140 beats/min (range 120-180). The longest R-R interval observed was 9 seconds. No difference was found in regard to the lateralisation of seizures and cardiac arrhytmia. One of the patients with bradycardia was fitted with a demand cardiac pacemaker, which appeared to decrease the number of his falls. In conclusion, ictal cardiac changes which may be seen in temporal lobe epilepsy (TLE) are sinus tachycardia and occasionally sinus bradycardia. Patients presenting vague complains suggestive of either TLE or cardiac dysrhythmia, simultaneous monitoring with EEG/ECG is required, and if the episodes are frequent, video-EEG should be considered. Further studies on this subject are warranted as this may shed some light on possible mechanisms for SUDEP.
Electrocardiographic changes in patients with refractory epilepsy
Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 2013
Epilepsy is the second most common type of chronic neurological disease. Its diagnosis carries an excess mortality, which is 2-3 times higher than that of general population. Mortality rates are increased among patients with uncontrolled seizures. The aim of this study was to characterize the electrocardiogram (ECG) changes during pre-ictal, ictal and post-ictal states in pharmaco-resistant epilepsy patients. This retrospective study conducted by Department of Neurology and Department of Cardiology of Isfahan Medical University from September 2008 to December 2012, patients with medically refractory epilepsy who underwent standard pre-surgical assessment from Epilepsy ward of Kashani hospital in Isfahan city were recruited in this study. The heart rate (HR) varied significantly throughout the record. Significant difference in HR was identified between ictal and pre-ictal periods (P = 0.000), furthermore, the difference between ictal and pre-ictal HR {mean = 63.867 ± 0.061, P = 0.000...