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Cardiac rhythm during temporal lobe seizures.

M A Epstein¹, M R Sperling, M J O'Connor

¹Comprehensive Epilepsy Center, Graduate Hospital, University of Pennsylvania School of Medicine, Philadelphia.

|January 1, 1992

Summary

Ictal tachycardia, or rapid heart rate during seizures, is linked to the brain regions involved, not seizure duration. The amygdala plays a minimal role; broader seizure involvement drives heart rate changes.

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Area of Science:

Neuroscience
Epilepsy Research
Cardiovascular Physiology

Background:

Ictal tachycardia is a common phenomenon during epileptic seizures.
The specific neuroanatomic drivers of ictal tachycardia remain incompletely understood.
Previous research has implicated various brain regions, including the temporal lobe and amygdala.

Purpose of the Study:

To investigate the neuroanatomic correlates of ictal tachycardia in patients with temporal lobe epilepsy.
To determine the relationship between seizure spread, brain region recruitment, and heart rate changes.
To clarify the role of the amygdala in modulating heart rate during seizures.

Main Methods:

Analysis of 27 seizures from five patients with unilateral temporal lobe epilepsy.

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Utilized bilateral temporal lobe depth electrodes and orbitofrontal subdural electrodes for ictal monitoring.

Correlated heart rate (HR) increases with electroencephalogram (EEG) findings and seizure spread patterns.

Main Results:

Heart rate increased progressively as new cortical regions were recruited into the seizure.
HR changes correlated with the volume of brain involved, not seizure duration.
Seizure activity restricted to the amygdala was insufficient to significantly alter heart rate.
HR plateaued with recruitment of new regions, irrespective of EEG frequency shifts.

Conclusions:

Ictal tachycardia is primarily dependent on the extent of cerebral structures recruited during a seizure.
The amygdala appears to have a limited role in modulating heart rate during seizures.
Understanding these neuroanatomic correlates can inform epilepsy management and autonomic dysfunction research.