Autonomic Nervous System and Epilepsy

Wannamaker, Braxton B.

doi:10.1111/j.1528-1157.1985.tb05722.x

Cited by 102 publications

(56 citation statements)

References 51 publications

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“…[7][8][9][10] Moreover, patients with carbamazepine have been suggested to be overrepresented among subjects experiencing SUDEP. 11 Ictal changes in heart rate (HR), blood pressure (BP), and other autonomic functions have been described in detail in patients with epilepsy, 12 but little is known about the possible interictal alterations of cardiovascular autonomic regulation. Previous studies, based on short term ECG recordings under laboratory conditions or ambulatory ECG recordings suggest that HR variability is reduced in temporal lobe epilepsy (TLE).…”

mentioning

confidence: 99%

Heart rate dynamics in refractory and well controlled temporal lobe epilepsy

Ansakorpi

Korpelainen²,

Huikuri³

et al. 2002

Journal of Neurology, Neurosurgery &Amp; Psychiatry

139

111

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Objectives: Disorders of cardiovascular and other autonomic nervous system functions are often found in patients with temporal lobe epilepsy (TLE). Cardiovascular dysregulation in TLE has previously been quantified assessing traditional time and frequency domain measures of heart rate (HR) variability from short term ECG recordings. However, new complexity and fractal measures of HR variability based on non-linear dynamics and fractals ("chaos theory") may disclose certain patterns of HR dynamics that cannot be detected using only conventional measures. Methods: In addition to the traditional spectral and non-spectral components of HR variability, fractal correlation properties, approximate entropy (ApEn) of RR interval dynamics, and the slope of the power law relation were measured from 24 hour ambulatory ECG recordings to evaluate interictal autonomic cardiovascular regulatory function in 19 patients with refractory TLE, 25 patients with well controlled TLE, and in 34 healthy age and sex matched control subjects. Results: The traditional time and frequency domain measures were lower in patients with TLE than in controls (p<0.05). In addition, the power law slope (p<0.005) and ApEn (p<0.05) were also reduced in TLE patients. Furthermore, ApEn was smaller in patients with refractory TLE than in patients with wellcontrolled TLE ( p<0.01), whereas the long term fractal correlation value α2 was lower in patients with well controlled TLE (p<0.05). An altered HR variation was not associated with any particular AED regimen. Conclusions: In addition to reduced overall HR variability, the long term fractal organisation and complexity of HR dynamics seem to be altered in TLE. These abnormalities in HR behaviour may partly contribute to the occurrence of adverse cardiovascular events, such as life threatening arrhythmias in patients with TLE.

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confidence: 99%

Heart rate dynamics in refractory and well controlled temporal lobe epilepsy

Ansakorpi

Korpelainen²,

Huikuri³

et al. 2002

Journal of Neurology, Neurosurgery &Amp; Psychiatry

139

111

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“…Although respiratory arrest or compromise often accompanies various types of seizures, apnea can occur as an isolated ictal manifestation (1). Breath-holding spells are common, especially in preterm or sick newborns with various underlying disorders.…”

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confidence: 99%

Partial Seizures Manifesting As Apnea Only in an Adult

et al. 1999

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Summary:Purpose: Although several cases of apneic seizures have been reported in neonates, epileptic seizures presenting as apnea only in adults are very rare. We present a case report of a 19-year-old man with viral encephalitis and frequent episodes of apneic seizures.Methods: Prolonged electroencephalograms (EEGs), repiratory monitorings, and imaging including ictal-interictal subtraction single photon emission computed tomography (SPECT) coregistered with magnetic resonance imaging (MRI) were performed.Results: Ictal EEGs recorded during apneic episodes showed repetitive sharp waves or rhythmic theta activity arising from the left or right independent bitemporal region. Ictal SPECT was performed during one episode of apnea that showed ictal EEG discharges arising from the left posterior temporal area. Ictal-interictal subtraction SPECT coregistered with MRI revealed that the seizures originated from the left, posterior, midlateral temporal cortex.Conclusions: Previous studies with ictal EEG or brain stimulation suggest that apneic seizures might be mediated through the limbic and associated cortical systems. Our study reports on a very rare case of partial seizures with apnea only in an adult patient and is supported by ictal EEG and ictal-interictal subtraction SPECT coregistered with MRI. Key Words: Apneic seizure-Encephalitis-Limbic-Temporal lobe-Subtraction SPECT.Although respiratory arrest or compromise often accompanies various types of seizures, apnea can occur as an isolated ictal manifestation (1). Breath-holding spells are common, especially in preterm or sick newborns with various underlying disorders. Because seizures are not well organized in newborns, however, newborns with apnea should be examined for other signs of convulsive disorders as differentiated from other nonconvulsive causes of apneic attacks (2-7). A few cases of isolated apneic seizures, which usually last 1-2 min and can be documented by ictal electroencephalography (EEG) (8), have been reported in children. In contrast, seizures with apnea only are quite rare in adults, with only a few studies reporting that respiratory arrest or apnea can be produced by stimulation of some brain structures in experimental animals and humans (9-11).Our study is a case report of a 19-year-old man with viral encephalitis and frequent attacks of apneic seizures that were documented by continuous EEG and respiraAccepted June 2, 1999. Address correspondence and reprint requests to Dr. S. B. Hong at Epilepsy Center, Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Seoul, Korea. tory monitoring as well as ictal-interictal subtraction single proton emission computed tomography (SPECT) coregistered with magnetic resonance imaging (MRI). CASE REPORTA 19-year-old man was first seen in the emergency room of a local hospital with status epilepticus on February 17, 1998. He had neither a family history nor a medical history of seizures and had been healthy until then. After several days of flu-like symptoms, ...

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“…However, as a link in autonomic regulation, the temporal lobe might be important in maintenance of vital functions. 24 The presence of edema, atrophy, old lesions, and periventricular hypodensity on CT scan had no prognostic influence on survival within the first 3 weeks.…”

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confidence: 99%

Computed tomography in prognostic stroke evaluation.

Rasmussen

Köhler

Worm-Petersen

et al. 1992

Stroke

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Background and Purpose:Computed tomography is now routinely used in many hospitals to investigate cerebrovascular disease. The purpose of our prospective study was to determine whether cranial computed tomography in connection with neurological assessment was useful in prognostic evaluation of survival after acute stroke.Methods: Two-hundred forty-five consecutive stroke patients were included in the project during a 1-year period. Each had a detailed neurological assessment 24-72 hours after stroke onset and underwent cranial computed tomography without intravenous contrast injection within the first week after admission. The lesions were divided according to neuroanatomic regions. In the statistical analyses we used a multiple logistic regression model with survival/death as the binary variable.Results: Computed tomography showed 76% of the patients had infarcts, 11% had hemorrhages, and 13% had no acute lesion. Forty-three patients had more than one acute lesion, and 57 had one or more old infarctions. The temporal, parietal, and frontal regions and the basal ganglia were most often affected.Conclusions: We conclude that age, level of consciousness, and involvement of the temporal lobe on computed tomography were factors of prognostic significance regarding survival in the acute phase. (Stroke 1992;23:506-510)

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Autonomic Nervous System and Epilepsy

Cited by 102 publications

References 51 publications

Heart rate dynamics in refractory and well controlled temporal lobe epilepsy

Heart rate dynamics in refractory and well controlled temporal lobe epilepsy

Partial Seizures Manifesting As Apnea Only in an Adult

Computed tomography in prognostic stroke evaluation.

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