Does the type of seizure influence heart rate variability changes?
Maria Teresa Faria1, Susana Rodrigues2, Manuel Campelo3
1Nuclear Medicine Department, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal.
Epilepsy & Behavior : E&B
|December 5, 2021
Summary
Focal to bilateral tonic-clonic seizures (FBTCS) significantly impact autonomic cardiac function more than other seizure types in epilepsy patients. This reduction in vagal tone may increase the risk of sudden unexpected death in epilepsy (SUDEP).
Area of Science:
- Cardiology
- Neurology
- Autonomic Neuroscience
Background:
- Heart rate variability (HRV) is a key indicator of autonomic cardiac activity, with lower HRV linked to increased SUDEP risk in epilepsy patients.
- Generalized tonic-clonic seizures are a known SUDEP risk factor, yet the specific impact of seizure types on cardiac function remains unclear.
Purpose of the Study:
- To investigate the differential effects of focal to bilateral tonic-clonic seizures (FBTCS) versus non-FBTCS on periictal HRV in patients with refractory epilepsy.
- To assess the relative risk of different seizure types on cardiac autonomic function.
Main Methods:
- A 48-hour Holter recording was conducted on 121 epilepsy patients.
- Included patients had both FBTCS and non-FBTCS, with the first seizure of each type analyzed.
- HRV parameters were evaluated in 5-minute pre- and postictal epochs.
Main Results:
- FBTCS, compared to non-FBTCS, led to significantly lower postictal AVNN, RMSSD, pNN20, LF, and HF, and higher LF/HF and heart rate (HR).
- FBTCS induced significant increases in HR and LF/HF, and decreases in AVNN, RMSSD, pNN20, and HF from preictal to postictal periods.
- Non-FBTCS resulted in only minor changes in HR (decrease) and AVNN (increase).
Conclusions:
- FBTCS exert a more profound impact on cardiac autonomic function than other seizure types in refractory epilepsy.
- The significant reduction in vagal tonus following FBTCS may contribute to an elevated risk of SUDEP.
Keywords:
Focal to bilateral tonic-clonic seizuresGeneralized tonic-clonic seizuresHeart rate variabilityRefractory epilepsySUDEPMore Related Videos
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