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Ictal electrocardiographic changes in children presenting with seizures
Uğur Işik1, Canan Ayabakan, Kürşat Tokel
1Department of Pediatrics, Division of Pediatric Neurology, Acibadem University, Istanbul, Turkey. uisik@asg.com.tr
Summary
Tachycardia is the primary cardiac change observed in children during seizures. While ictal bradycardia and arrhythmias are rare in children, tachycardia is consistently present, differing from adult seizure patterns.
Area of Science:
- Pediatric Neurology
- Clinical Cardiology
- Epileptology
Background:
- Electrocardiographic (ECG) changes during seizures in children require further elucidation.
- Understanding these changes is crucial for comprehensive seizure management.
Purpose of the Study:
- To investigate specific electrocardiographic alterations in children experiencing seizures.
- To characterize heart rate, RR intervals, and QT intervals during ictal and peri-ictal periods.
Main Methods:
- Prospective analysis of 47 seizures in 18 pediatric patients undergoing video electroencephalography monitoring.
- Continuous measurement of RR and QT intervals for 60 seconds before, during, and after seizures.
- Assessment of heart rate, heart rate-corrected QT (QTc) intervals, and RR interval variability.
Main Results:
- All seizures were accompanied by tachycardia; no ictal bradycardia was observed.
- The mean ictal heart rate-corrected QT (QTc) interval was significantly higher than postictal measurements (P=0.005).
- RR interval variance and standard deviation significantly decreased during seizures, indicating reduced heart rate variability.
Conclusions:
- Tachycardia is the predominant electrocardiographic finding during pediatric seizures.
- Ictal bradycardia and cardiac arrhythmias are uncommon in children, unlike in adults with seizures.
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