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Published on: December 18, 2016
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Atrioventricular Conduction in Mesial Temporal Lobe Seizures.
Max C Pensel1, Luca M Basili2, Arthur Jordan3
1Department of Psychiatry, University Hospital Bonn, Bonn, Germany.
Frontiers in Neurology
|May 17, 2021
Summary
Seizures originating in the left temporal lobe in epilepsy patients show greater changes in atrioventricular (AV) conduction. This suggests lateralized brain control over heart function, potentially impacting cardiac complications in epilepsy.
Area of Science:
- Neuroscience
- Cardiology
- Epilepsy Research
Background:
- Epilepsy, particularly mesial temporal lobe epilepsy (mTLE), can be associated with cardiac complications like arrhythmias.
- Asymmetric brain control of autonomic functions may influence the severity of these cardiac events.
Purpose of the Study:
- To investigate seizure-related changes in atrioventricular (AV) conduction.
- To determine if these AV conduction alterations are dependent on the seizure's hemisphere of origin in mTLE patients.
Main Methods:
- Analysis of EEG and ECG data from 14 pharmacoresistant mTLE patients undergoing pre-surgical video-EEG telemetry.
- Measurement of RR and PR intervals during seizures originating from either the left or right hippocampus.
- Statistical analysis using paired t-tests and linear regression to assess PR/HR correlations.
Main Results:
- No significant difference in absolute PR intervals or heart rate (HR) between left- and right-sided seizures.
- A significantly steeper PR/HR correlation slope was observed during left-sided seizures, indicating greater peri-ictal modulation of AV conduction.
- No instances of prolonged PR intervals (>200 ms) or complete AV block occurred.
Conclusions:
- Mesial temporal lobe seizures are associated with a shortening of PR intervals, with a more pronounced effect observed in seizures originating from the left hippocampus.
- These findings support the concept of lateralized cerebral control over cardiac autonomic function.
- The subtle changes suggest a potential lateralized susceptibility to seizure-related AV node dysfunction in mTLE, though clinical relevance requires further investigation.
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