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Related Experiment Videos

Ictal ECG changes in temporal lobe epilepsy

L M Li1, J Roche, J W Sander

  • 1Epilepsy Research Group, Institute of Neurology, London, UK.

Arquivos De Neuro-Psiquiatria
|September 1, 1995
PubMed
Summary

Cardiac rhythm changes, including tachycardia and bradycardia, are common during epileptic seizures. Simultaneous EEG/ECG monitoring is recommended for patients with suspected temporal lobe epilepsy or cardiac dysrhythmia.

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Area of Science:

  • Neurology
  • Cardiology
  • Epileptology

Background:

  • Sudden unexpected death in epilepsy (SUDEP) may be linked to cardiac rhythm changes during seizures.
  • Understanding ictal cardiac events is crucial for patient management and SUDEP research.

Purpose of the Study:

  • To investigate the occurrence and characteristics of electrocardiogram (ECG) changes during complex partial seizures of temporal lobe origin.
  • To explore the relationship between seizure lateralization and cardiac arrhythmias.
  • To assess the potential impact of cardiac pacing on seizure-related falls.

Main Methods:

  • Electrocardiogram (ECG) monitoring during 61 complex partial seizures in 20 patients with temporal lobe epilepsy (TLE).
  • Analysis of heart rate variability, including tachycardia and bradycardia.
  • Correlation of cardiac events with seizure lateralization.
  • Case observation of a patient with bradycardia fitted with a cardiac pacemaker.

Main Results:

  • Sinus tachycardia was observed in 39% of seizures, with mean rates around 139-140 bpm.
  • Sinus bradycardia occurred in 5% of seizures, with one instance showing a prolonged R-R interval of 9 seconds.
  • No significant difference in cardiac arrhythmia was found based on seizure lateralization.
  • A patient with bradycardia experienced reduced falls after pacemaker implantation.

Conclusions:

  • Ictal cardiac changes in TLE commonly include sinus tachycardia and sometimes sinus bradycardia.
  • Simultaneous EEG/ECG monitoring is advised for patients with ambiguous symptoms of TLE or cardiac dysrhythmia.
  • Further research into ictal cardiac events may elucidate SUDEP mechanisms.

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