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Related Experiment Videos

EKG abnormalities during partial seizures in refractory epilepsy.

M Nei1, R T Ho, M R Sperling

  • 1Jefferson Comprehensive Epilepsy Center, Department of Neurology, Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA. maromi.nei@mail.tju.edu

Epilepsia
|May 10, 2000
PubMed
Summary

Cardiac rhythm and conduction abnormalities are common during seizures in patients with intractable epilepsy, especially with prolonged or generalized seizures. These findings suggest a potential link to sudden unexpected death in epilepsy (SUDEP).

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Area of Science:

  • Cardiology
  • Neurology
  • Epilepsy Research

Background:

  • Sudden unexpected death in epilepsy (SUDEP) is a significant concern in patients with refractory epilepsy.
  • Cardiac arrhythmias during seizures are a potential mechanism contributing to SUDEP.

Purpose of the Study:

  • To determine the frequency and characteristics of ictal cardiac rhythm and conduction abnormalities in intractable epilepsy.
  • To investigate the relationship between seizure characteristics and cardiac abnormalities.

Main Methods:

  • Prospective analysis of 51 seizures in 43 patients with intractable partial epilepsy using CCTV-EEG and a single ECG channel.
  • Evaluation of arrhythmias, repolarization abnormalities, and PR and QTc intervals during preictal, ictal, and postictal periods.
  • Application of parametric and nonparametric statistical methods for data analysis.

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Main Results:

  • 39% of patients exhibited cardiac rhythm and/or repolarization abnormalities during or immediately after seizures.
  • Abnormalities included various arrhythmias (asystole, atrial fibrillation, sinus arrhythmia, SVT, APDs, VPDs) and bundle-branch block.
  • Longer mean seizure duration and generalized tonic-clonic seizures were associated with increased ictal ECG abnormalities.

Conclusions:

  • Cardiac rhythm and conduction abnormalities frequently occur during seizures in intractable epilepsy.
  • These abnormalities are more prevalent in prolonged or generalized seizures.
  • The findings support the hypothesis that ictal cardiac events may contribute to SUDEP.