John Libbey Eurotext

Changes in heart rate during the peri-ictal period in focal epilepsy Article à paraître

Illustrations

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Tableaux

Auteurs
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
2 Department of Neurology, Anyang District Hospital of Henan Province, Anyang 455000, China
3 Department of Cardiac Surgery, Anyang District Hospital of Henan Province, Anyang 455000, China
4 China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
5 Department of Radiology, Baoding Second People’s Hospital, Baoding 071051, China
6 Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100069, China
Correspondence:
Qun Wang,
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China

Objective

We explored changes in heart rate during the peri-ictal period in patients with focal epilepsy, and differences in heart rate changes according to epileptic site and side were assessed.

Methods

A total of 198 epileptic seizures in 102 patients with focal epilepsy, who had a definite epileptogenic focus and had undergone surgical treatment, were assessed from 2014 to 2019. Heart rate was measured manually during the peri-ictal period. Change in heart rate and the time it occurred were assessed and compared between different epileptic sites and sides.

Results

Heart rate increased in 177 (89.4%) of 198 seizures. In 82 (44.8%) of 183 seizures, the change in heart rate occurred before seizure onset. The median period of heart rate change was seven seconds (interquartile range: 3–11 seconds) in seizures with heart rate change before seizure onset. The number of seizures with heart rate increase before seizure onset was significantly greater for medial temporal lobe epilepsy compared to lateral temporal lobe epilepsy (p=0.019) and extratemporal lobe epilepsy (p=0.002).

Significance

A change in heart rate prior to seizure onset is more likely to occur in patients with medial temporal lobe epilepsy, compared to those with lateral temporal lobe epilepsy and extratemporal lobe epilepsy. Patients with medial temporal lobe epilepsy may likely benefit from seizure warning and detection devices.