Seizure: European Journal of Epilepsy
Volume 19, Issue 5 , Pages 291-295, June 2010

Is elevated pre-ictal heart rate associated with secondary generalization in partial epilepsy?

  • Kristian Bernhard Nilsen

      Affiliations

    • Norwegian University of Science and Technology, Department of Clinical Neurosciences, Trondeim, Norway
    • St. Olavs Hospital, Department of Neurology and Clinical Neurophysiology, Trondheim, Norway
    • Oslo University Hospital, Department of Neurology, Section for Clinical Neurophysiology, Norway
    • Corresponding Author InformationCorresponding author at: Oslo University Hospital, Department of Neurology, Section for Clinical Neurophysiology, O407 Oslo, Norway. Tel.: +47 9137 2241; fax: +47 2211 8580.
    • ,
  • Marit Haram

      Affiliations

    • Norwegian University of Science and Technology, Department of Clinical Neurosciences, Trondeim, Norway
    • Both authors contributed equally.
    • ,
  • Solveig Tangedal

      Affiliations

    • Norwegian University of Science and Technology, Department of Clinical Neurosciences, Trondeim, Norway
    • Both authors contributed equally.
    • ,
  • Trond Sand

      Affiliations

    • Norwegian University of Science and Technology, Department of Clinical Neurosciences, Trondeim, Norway
    • St. Olavs Hospital, Department of Neurology and Clinical Neurophysiology, Trondheim, Norway
    • ,
  • Eylert Brodtkorb

      Affiliations

    • Norwegian University of Science and Technology, Department of Clinical Neurosciences, Trondeim, Norway
    • St. Olavs Hospital, Department of Neurology and Clinical Neurophysiology, Trondheim, Norway

Received 30 September 2009; received in revised form 16 February 2010; accepted 18 March 2010. published online 16 April 2010.

Abstract 

Background

People with epilepsy are at risk for sudden unexpected death. Cardiac arrhythmia is one possible mechanism. We have studied seizure-related changes in cardiac rhythm.

Methods

Video-EEG and ECG from 38 patients with epileptic seizures during long-term monitoring for investigation of partial epilepsy with ictal impairment of consciousness were obtained. Seizures were classified as either complex partial or secondarily generalized. Inter-ictal, pre-ictal, ictal and post-ictal heart rate was calculated for the first recorded seizure.

Results

Heart rate during the pre-ictal period was higher (p=0.016) in patients with secondarily generalized seizures (n=11) compared to patients with complex partial seizures (n=27). Heart rate was also elevated during and after generalized seizures (p<0.015). Inter-ictal heart rate was not different in patients with secondary generalization compared to patients with partial seizures.

Conclusion

We report elevated heart rate prior to partial seizure onset in those attacks which become secondarily generalized compared to seizures which remain localized. The finding may be relevant for the understanding of sudden death in epilepsy.

Keywords: Autonomic nervous system, Temporal lobe, SUDEP, Seizure prediction

 

PII: S1059-1311(10)00057-9

doi:10.1016/j.seizure.2010.03.003

Seizure: European Journal of Epilepsy
Volume 19, Issue 5 , Pages 291-295, June 2010

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