Is elevated pre-ictal heart rate associated with secondary generalization in partial epilepsy?

Nilsen, Kristian Bernhard; Haram, Marit; Tangedal, Solveig; Sand, Trond; Brodtkorb, Eylert

doi:10.1016/j.seizure.2010.03.003

Cited by 27 publications

(49 citation statements)

References 26 publications

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“…The mean HR differences of SPS, CPS and CPS-G were (47.5 ± 24.9), (51.2 ± 19.8) and (80.5 ± 21.3) BPM, respectively. The HR changes in CPS-G seizures were the highest of the three types ( P < 0.01) (Table 3), which has been reported previously [23,11]. …”

Section: Discussionsupporting

confidence: 86%

“…Analysis shows that HR increases significantly in CPS-G compared to non-generalized seizures [10]. More insight into the mechanisms of generalization of partial seizures may improve treatment, and possibly also contribute to a reduced number of SUDEP, which has been reported previously [11]. HR increase seems more prominent in temporal lobe seizures (where insular spread is common), compared with extratemporal seizures [12-14].…”

Section: Introductionmentioning

confidence: 93%

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Heart rate changes in partial seizures: analysis of influencing factors among refractory patients

et al. 2014

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BackgroundWe analyzed the frequency of heart rate (HR) changes related to seizures, and we sought to identify the influencing factors of these changes during partial seizures, to summarize the regularity of the HR changes and gain some insight into the mechanisms involved in the neuronal regulation of cardiovascular function. To date, detailed information on influencing factors of HR changes related to seizures by multiple linear regression analysis remains scarce.MethodsUsing video-electroencephalograph (EEG)-electrocardiograph (ECG) recordings, we retrospectively assessed the changes in the HR of 81 patients during a total of 181 seizures, including 27 simple partial seizures (SPS), 110 complex partial seizures (CPS) and 44 complex partial seizures secondarily generalized (CPS-G). The epileptogenic focus and the seizure type, age, gender, and sleep/wakefulness state of each patient were evaluated during and after the seizure onset. The HR changes were evaluated in the stage of epilepsy as time varies.ResultsOf the 181 seizures from 81 patients with ictal ECGs, 152 seizures (83.98%) from 74 patients were accompanied by ictal tachycardia (IT). And only 1 patient was accompanied by ictal bradycardia (IB). A patient has both IT and IB. We observed that HR difference was independently correlated with side, type and sleep/wakefulness state. In this analysis, the HR changes were related to the side, gender, seizure type, and sleep/wakefulness state. Right focus, male, sleep, and CPS-G showed more significant increases than that were observed in left, female, wakefulness, SPS and CPS. HR increases rapidly within 10 seconds before seizure onset and ictus, and typically slows to normal with seizure offset.ConclusionCPS-G, sleep and right focus led to higher ictal HR. The HR in the stage of epilepsy has regularly been observed to change to become time-varying. The risk factors of ictal HR need to be controlled along with sleep, CPS-G and right focus. Our study first explains that the HR in seizures has a regular evolution varying with time. Our study might help to further clarify the basic mechanisms of interactions between heart and brain, making seizure detection and closed-loop systems a possible therapeutic alternative in refractory patients.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 93%

Heart rate changes in partial seizures: analysis of influencing factors among refractory patients

et al. 2014

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“…In another study in children, ictal tachycardia was present in 70% of focal seizures (temporal or frontal onset), but not in A c c e p t e d M a n u s c r i p t generalized seizures [75]. One interesting study found that heart rate increased from the preictal to the ictal period in 74% of the patients and it was higher in seizures with secondary generalization than in complex partial seizures [76]. One of the few studies that included generalized seizures detected heart rate changes in 35% of seizures, either GTCS or secondarily generalized seizures [65].The sensitivity of the automated detection algorithms was 90-98% in seizures with heart rate changes, with a greater than 50% positive predictive value [64,77].…”

Section: Electrocardiogram (Ekg)mentioning

confidence: 92%

Automated seizure detection systems and their effectiveness for each type of seizure

Ulate‐Campos

Coughlin

Gaínza‐Lein

et al. 2016

Seizure

195

166

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Epilepsy affects almost 1% of the population and most of the approximately 20-30% of patients with refractory epilepsy have one or more seizures per month. Seizure detection devices allow an objective assessment of seizure frequency and a treatment tailored to the individual patient. A rapid recognition and treatment of seizures through closed-loop systems could potentially decrease morbidity and mortality in epilepsy. However, no single detection device can detect all seizure types. Therefore, the choice of a seizure detection device should consider the patient-specific seizure semiologies. This review of the literature evaluates seizure detection devices and their effectiveness for different seizure types. Our aim is to summarize current evidence, offer suggestions on how to select the most suitable seizure detection device for each patient and provide guidance to physicians, families and researchers when choosing or designing seizure detection devices. Further, this review will guide future prospective validation studies.

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“…Chronic epileptiform discharges or epileptic foci in these areas may produce potentially life-threatening cardiac arrhythmias both ictally and interictally as cardiovascular regulation is, in fact, a function of neuronal activity in the cerebral cortex, the amygdale, and the medullary reticular formation [18, 29, 43–46]. It has been suggested in the context of increased preictal HR that in patients with primarily more instability and activation in cortical networks surrounding the seizure onset zone will simultaneously increase sympathetic tone and risk for generalization of the seizure, since noradrenergic function may be needed for the anticonvulsive effect of the vagus nerve stimulation, at least in animals [47]. However, on the other hand, it has also been shown that secondarily generalized seizures lead to higher ictal HR and sustained postictal tachycardia with enhanced shortening of QT-interval possible showing that cardiac alterations are in fact a link between generalized seizures and SUDEP [48].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Heart Rate Variation Analysis during Rest and Tilting in Patients with Temporal Lobe Epilepsy

Ansakorpi

Korpelainen²,

Suominen³

et al. 2011

Neurology Research International

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Objective. To evaluate spectral heart rate (HR) variation using short-term ECG recordings at rest and during the tilt table test. Methods. The values of spectral components of total power (TP), high-frequency power (HF), low-frequency power (LF) and LF: HF ratio were measured at rest and during the head-up tilt in patients with temporal lobe epilepsy (TLE) and their control subjects. Results. Compared to the control subjects, patients with TLE had lower HF (P < 0.05) and LF : HF ratio (P < 0.05) at rest and lower TP (P < 0.001), HF (P < 0.05), and LF (P < 0.05) during the head-up tilt. Upon changing from supine to standing position TP (P < 0.05) and LF (P < 0.05) were attenuated in patients with TLE compared to the control subjects. Conclusion. These results suggest that spectral analysis of HR variation from ECG recordings of short duration may add value to assessment of autonomic nervous system function using autonomic cardiac tests in patients with TLE.

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Is elevated pre-ictal heart rate associated with secondary generalization in partial epilepsy?

Abstract: We report elevated heart rate prior to partial seizure onset in those attacks which become secondarily generalized compared to seizures which remain localized. The finding may be relevant for the understanding of sudden death in epilepsy.

Cited by 27 publications

References 26 publications

Heart rate changes in partial seizures: analysis of influencing factors among refractory patients

Heart rate changes in partial seizures: analysis of influencing factors among refractory patients

Automated seizure detection systems and their effectiveness for each type of seizure

Evaluation of Heart Rate Variation Analysis during Rest and Tilting in Patients with Temporal Lobe Epilepsy

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