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How common is ictal hypoxemia and bradycardia in children with partial complex and generalized convulsive seizures?

Brian D Moseley1, Katherine Nickels, Jeffrey Britton

  • 1Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA. moseley.brian@mayo.edu

Epilepsia
|January 14, 2010
PubMed

Insights

Ictal hypoxemia (low oxygen) is common in children during seizures, especially generalized ones or when tapering antiepileptic drugs (AEDs). Ictal bradycardia (slow heart rate) occurred only in specific partial complex seizures.

Area of Science:

  • Pediatric Neurology
  • Epilepsy Research
  • Autonomic Dysfunction

Background:

  • Autonomic nervous system dysfunction during seizures can lead to cardiorespiratory abnormalities.
  • These autonomic effects may contribute to sudden unexpected death in epilepsy (SUDEP).
  • Understanding ictal autonomic events in children is crucial for risk assessment.

Purpose of the Study:

  • To determine the prevalence of ictal hypoxemia and ictal bradycardia in pediatric epilepsy patients.
  • To identify risk factors associated with these ictal autonomic events.

Main Methods:

  • Retrospective review of medical records from an Epilepsy Monitoring Unit (EMU).
  • Analysis of oximetry and heart rate data from children experiencing partial complex or generalized convulsive seizures.
  • Inclusion criteria required recorded oximetry and/or heart rate data during seizures.

Main Results:

  • Ictal hypoxemia occurred in 48.9% of children and 26.8% of seizures.
  • Hypoxemia was more frequent in generalized seizures and during antiepileptic drug (AED) tapering.
  • Ictal bradycardia was observed in 8.2% of children, exclusively in extratemporal partial complex seizures, but was not statistically significant due to low prevalence.

Conclusions:

  • Ictal hypoxemia is a common ictal event in children with epilepsy, particularly with generalized seizures, prolonged partial complex seizures, and AED tapering.
  • Ictal bradycardia in this cohort was uniquely associated with extratemporal partial complex seizures.
  • Findings highlight the significance of monitoring autonomic function during pediatric seizures.
Abstract

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