Peri-ictal Heart Rate Changes in Patients With Localization-Related Epilepsy

J Korean Neurol Assoc > Volume 28(3); 2010 > Article

Journal of the Korean Neurological Association 2010;28(3): 179-185.

국소관련간질 환자의 발작 전후 심박수 변화

정은혜, 김원섭 양혜란 윤영신 이규선 최경규 박기덕 이향운

이화여자대학교 목동병원 신경과

Peri-ictal Heart Rate Changes in Patients With Localization-Related Epilepsy

Eun Eun Hye Jeong, Hye Jeong

Department of Neurology, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Korea

Abstract

Background: Epileptic seizures can be associated with changes in autonomic functions. This study evaluated heart rate (HR) changes at the transition from the preictal to the ictal state in patients with epileptic seizures, and investigated whether peri-ictal HR changes can help to predict electroencephalography (EEG) seizures prior to their onset.
Methods: We retrospectively studied 94 seizures in 33 patients who underwent video-EEG monitoring with scalp EEG and electrocardiography. The existence and initial timing of HR changes relative to the onset of EEG seizures were determined by analyzing consecutive RR-interval changes in 10-minute recordings. We evaluated the correlation between the peri-ictal HR changes and the type of localization-related epilepsy.
Results: Peri-ictal HR changes were documented in 70.2% (66/94) of all seizures, of which 62 were tachycardia (66.0%) and 4 were bradycardia (4.3%). Peri-ictal tachycardia occurred significantly with seizures as an ictal manifestation, more often in seizures with a right hemispheric onset than in those with a left hemispheric onset (77.4% vs. 50%, p=0.016). Peri-ictal HR changes were observed much earlier in seizures of mesial temporal lobe epilepsy (TLE) than in those of extratemporal lobe epilepsy (?54.4 s vs. ?6.7 s, p<0.001).
Conclusions: Peri-ictal HR changes were observed in 70.2% of seizures, 94% of which were tachycardia. These changes could be helpful in predicting seizure onset, especially in mesial TLE. Key Words: Epileptic seizures, Autonomic, Heart rate, Ictal, Electrocardiography