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KMID : 0359720100280030179
Journal of the Korean Neurological Association
2010 Volume.28 No. 3 p.179 ~ p.185
Peri-ictal Heart Rate Changes in Patients With Localization-Related Epilepsy
Jeong Eun-Hye

Kim Won-Sup
Yang Hye-Ran
Yoon Young-Shin
Lee Kyu-Sun
Choi Kyoung-Gyu
Park Kee-Duk
Lee Hyang-Woon
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.
KEYWORD
Epileptic seizures, Autonomic, Heart rate, Ictal, Electrocardiography
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