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Author Spotlight: Unraveling Seizure Dynamics and Novel Therapeutics for Status Epilepticus Using CMOS High-Density Microelectrode Array Systems
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Hyperventilation in functional seizures: Evidence for subtypes.

Richard A Kanaan1, Saul A Mullen2, Wendyl D'Souza3

  • 1Department of Psychiatry, University of Melbourne, Austin Health, 145 Studley Road, LTB10, Heidelberg, VIC 3084, Australia; The Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC 3084, Australia.

Seizure
|May 5, 2022
PubMed
Summary
This summary is machine-generated.

Functional seizures (FS) show two distinct heart rate patterns before seizures, suggesting different underlying mechanisms. This finding may help classify these heterogeneous neurological events.

Keywords:
AnxietyAutonomic nervous systemHeart ratePre-ictalPsychogenic non-epileptic seizuresRespiratory rateVideo-EEG

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Area of Science:

  • Neurology
  • Clinical Neurophysiology

Background:

  • Functional seizures (FS) are a heterogeneous neurological condition without standardized classification.
  • A subset of FS patients experience seizures provoked by hyperventilation during EEG monitoring.

Purpose of the Study:

  • To investigate if hyperventilation-induced FS represent a distinct seizure mechanism.
  • To explore potential differences in pre-ictal heart rate patterns within FS subtypes.

Main Methods:

  • Analysis of video-EEG/ECG recordings from 107 patients with FS across two Melbourne hospitals (2010-2016).
  • Comparison of pre-ictal heart rate patterns in patients with hyperventilation-induced seizures versus those without.
  • Cluster analysis to identify distinct patient groups based on heart rate variability.

Main Results:

  • Two distinct pre-ictal heart rate patterns were identified in FS patients.
  • Patients with hyperventilation-induced seizures exhibited different heart rate profiles compared to those without.
  • Pre-ictal heart rate patterns, specifically baseline heart rate and its change before seizure onset, effectively clustered patients into two groups.

Conclusions:

  • Functional seizures exhibit at least two distinct pre-ictal heart rate patterns.
  • These patterns may indicate underlying differences in seizure generation mechanisms.
  • Pre-ictal heart rate analysis offers a potential method for subtyping functional seizures.