Cardiac Effects of Seizures (original) (raw)
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Effects of Seizures on Cardiac Function
Journal of Clinical Neurophysiology, 2010
Various chronic and acute autonomic effects on the heart are seen during epileptic seizures, and some have been implicated in cases of sudden unexpected death in epilepsy (SUDEP). Chronic autonomic dysfunction, either congenital or acquired through seizures or medications, and structural changes of the heart may all predispose patients to SUDEP. Acute autonomic changes during seizures, in particular ictal bradycardia or transient ischemia, may indicate an increased and preventable risk of mortality in patients with epilepsy. However, there is no definite epidemiologic evidence associating any of the chronic or acute cardiac effects of seizures with SUDEP. Cases of SUDEP and near-SUDEP recorded during long-term electroencephalography monitoring offer some insight into the potential mechanisms leading to SUDEP. These cases suggest that autonomic instability ending in cardiorespiratory arrest may be provoked by postictal suppression rather than by ictal activation of the autonomic nervous system. Additional epidemiologic studies on high-risk populations and access to recorded cases of SUDEP may provide more details about the exact sequence of events leading to death and thus guide the development of possible preventive strategies.
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.
Electrocardiographic Changes at the Onset of Epileptic Seizures
Epilepsia, 2003
Purpose: We studied heart-rate (HR) changes at the transition from the preictal to the ictal state in patients with focal epilepsies to gain some insight into the mechanisms involved in the neuronal regulation of cardiovascular function.
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...
Journal of Neurology & Neurophysiology, 2014
Objective: Little is known about the (peri-) ictal changes in autonomic nervous system activity of epileptic seizures. Such information may be useful for seizure prediction paradigms and differential diagnosis between epilepsy and psychogenic non-epileptic seizures (PNES). The current study investigated the peri-ictal time course of heart rate variability (HRV) measures, which reflect autonomic nervous system functioning. Methods: HRV measures were extracted from electrocardiography data collected during 1-7 days of videoelectroencephalography monitoring of 17 patients with epilepsy and 20 patients with PNES. Heart rate (HR) and HRV measures (standard deviation of average beat-to-beat intervals (SDANN), root mean square of successive differences (RMSSD), high frequency (HF) power, low frequency (LF) power and very low frequency (VLF) power) were averaged over consecutive five-minute intervals. Quantitative analyses of Poincaré plot parameters (SD1, SD2 and SD1/SD2 ratio) were also performed. In addition, differences with HRV parameters of patients with PNES were explored. Results: In epilepsy, no significant pre-ictal changes in HR and HRV parameters were observed. During seizures, HR, SDANN, SD1 and SD1/SD2 ratio significantly increased while VLF power significantly decreased. In the five-minute interval immediately following seizures, HR, SDANN and SD1 were back to pre-seizure levels, while VLF power remained significantly decreased and SD1/SD2 ratio remained significantly increased. Significant between-group differences were identified for several pre-ictal and ictal HRV parameters, but not for post-ictal measurements. Conclusion: The ictal HR and HRV changes reflect increased sympathetic system activation during epileptic seizures. The HRV parameters of patients with epilepsy differed significantly from the peri-ictal HRV pattern of patients with PNES, which suggested increased sympathetic system activation and decreased vagal tone shortly before PNES and return to normal levels shortly after the episode. Implications for differential diagnosis and treatment are discussed.
Partial Epileptic Seizures of Different Origin Variably Affect Cardiac Rhythm
Epilepsia, 1996
The present study was aimed at evaluating electrocardiographic (ECG) changes associated with partial epileptic seizures without seizure activity secondarily generalized. Methods: We assessed heart rate (HR) changes occurring during 100 partial epileptic seizures, as recorded by ambulatory EEG-ECG in 50 outpatients. Consecutive R-R intervals were measured for the 30 s immediately preceding the onset and for the first 10-s period of discharge. In addition, HR was sampled at 10-s intervals during EEG paroxysmal discharge and for 1 min after the end of discharge. Results: The highest and lowest respective HR peaks achieved during these seizures were 186 and 44 beats/ min. Analysis of the R-R intervals during the first 10-s period of EEG discharge showed a significant early HR increase in 49% of the seizures; the corresponding figure for an early HR reduction was 25.5%. Eighty percent of the seizures showing an early HR decrease were of temporal lobe origin. No severe cardiac arrhythmias were noted during the seizures. Conclusions: Our data suggest that an early HR decrease is more probable in temporal lobe seizures than in seizures of other origin. An accurate HR measurement, focused on discharge onset, may provide both a reliable way of evaluating the possible effect of partial seizures on HR and valuable information about the cerebral sites involved in the control of cardiac rhythm.