Central cardio-autonomic disorganization in interictal states of epilepsy detected by phase space analysis

In a study of central autonomic organization in interictal states of idiopathic generalized epilepsy, we measured the spontaneous oscillations of the heart rate in 8 young epileptics with normal interictal electroencaphalograms (EEGs), 6 young epileptics with epileptiform discharges in the interictal EEGs and 8 healthy controls. The temporal structure of the heart rate (HR) dynamics was operationalized through the estimation of the largest Lyapunov exponent (LLE). For all patients and controls, the LLEs of the HR dynamics were positive, indicating chaotic oscillations. The patients with interictal epileptiform discharges showed significantly lower LLEs of the HR dynamics than the epileptics with normal EEGs and the healthy controls. By comparison, the values of the epileptics with normal EEGs und those of the healthy controls did not differ significantly. This finding suggests a more rigid and thus less adaptable central cardio-autonomic organization in epileptics with epileptiform discharges in the interictal EEG.