EKG abnormalities in children and adolescents with symptomatic temporal lobe epilepsy

Mayer, H.; Benninger, Franz; Urak, L.; Plattner, Belinda; Geldner, Julia; Feucht, Martha

doi:10.1212/01.wnl.0000129830.72973.56

Cited by 97 publications

(112 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We considered the comparison of insular effects based on the laterality of the lesion, in order to highlight central modulation effects on heart rate variability in patients at risk for cardiac events [60]. To our knowledge, the evidence to support an effect of seizure lateralization on heart rate in the literature was inconclusive [61], but it was suggested that events with increase in heart rate are more highly influenced by the right anatomic structures [62][63][64][65].…”

Section: Therapeutic Perspectivesmentioning

confidence: 99%

Cortical lateralization and cardiac autonomic control. Insights from insular stroke and epilepsy

Constantinescu¹,

Detante²,

Matei³

et al. 2017

Arch Clin Cases

View full text Add to dashboard Cite

Autonomic nervous system dysfunction is a common complication of stroke. Human studies and experimental data showed a hemispheric lateralization of autonomic activity concerning the forebrain and particularly the insular cortex. Insular cortex involvement is associated with more pronounced autonomic imbalance leading to life threatening arrhythmias and sudden death. We present two case reports of insular infarction in young patients without any cardiac comorbidity, illustrating a specific lateralized function of insula and its influence on the sympatho-vagal balance that implied differentiated therapeutic management after stroke. The right insular stroke was associated to sympathetic activation and left insular stroke was associated to parasympathetic predominance. The same lateralization of autonomic function with opposite effects on sympatho-vagal balance was also reported in two insular epilepsy cases, illustrating the fact that, beyond the controlling network, the cortical modulation of the autonomic nervous system is asymmetric. Identifying high risk patients prone to develop neurogenic cardiac complications, by better understanding of dysautonomia pathophysiology and consequent implementation of prophylactic and therapeutic interventions may significantly reduce mortality rate in stroke and epilepsy.

show abstract

Section: Therapeutic Perspectivesmentioning

confidence: 99%

Cortical lateralization and cardiac autonomic control. Insights from insular stroke and epilepsy

Constantinescu¹,

Detante²,

Matei³

et al. 2017

Arch Clin Cases

View full text Add to dashboard Cite

show abstract

“…127 Heart rate abnormalities have been found to accompany CPS in drug-resistant children and adolescents, which may contribute to the occurrence of SUDEP. 128 The prognosis for patients with IS, however, is poor. Between 70 and 90% exhibit learning difficulties or mental retardation, 8 and psychiatric symptoms are common in patients, occurring in 20 -40% of adults with a history of IS.…”

Section: Consequences Of Uncontrolled Seizuresmentioning

confidence: 99%

Vigabatrin

2007

View full text Add to dashboard Cite

Summary: Refractory epilepsies such as infantile spasms (IS) and complex partial seizures (CPS) can have a severe negative impact on the neurological integrity and quality of life of affected patients, in addition to drastically increasing their risk of premature mortality. Early identification of potentially effective pharmacotherapy agents is important. Vigabatrin has been shown to be a generally well tolerated and effective antiepileptic drug (AED) in a wide variety of seizure types affecting both children and adults, particularly those with IS and CPS. A bilateral, concentric constriction of the peripheral visual field characterizes the visual field defect (VFD) associated with vigabatrin, well characterized by numerous studies. This peripheral VFD presents in 30 -50% of patients with exposure of several years; however, most of these patients are asymptomatic. In well-controlled studies, the earliest onset in patients with CPS is 11 months and at 5 months in infants, with average onsets being more than 5 years and 1 year, respectively. Patients with a peripheral VFD retain an average 65°of lateral vision (normal, 90°). The fact that many patients never develop the vigabatrin-related peripheral VFD, despite long-term exposure at high doses, may support the hypothesis that the injury is an idiosyncratic adverse drug reaction (as opposed to a strict dose-or duration-dependent toxicity). Effective testing methods are available to aid in the early detection and management of the peripheral VFD. This article discusses issues of importance to clinical decision-making in the use of vigabatrin to assist the physician and patient in assessing the benefits of vigabatrin therapy and understanding the potential risks of the VFD and uncontrolled seizures.

show abstract

“…There is some evidence confirming the right hemispheric lateralization of sympathetic cardiac control in epileptic patients (Mandic et al, 2010;Mayer et al, 2004;McKee & Bodfish, 2000). Therefore, the primary goal of this study was to investigate whether there is any different behavior in HRV of epileptic patients based on their gender.…”

Section: Research-article2016mentioning

confidence: 96%

Gender-Related Differences in Heart Rate Variability of Epileptic Patients

et al. 2016

View full text Add to dashboard Cite

Recently, heart rate variability (HRV) analysis has been used as an indicator of epileptic seizures. As women have a lower sudden, unexpected death in epilepsy risk and greater longevity than men, the authors postulated that there are significant gender-related differences in heart rate dynamics of epileptic patients. The authors analyzed HRV during 5-minute segments of continuous electrocardiogram recording of age-matched populations. The middle-aged epileptic patients included males (n = 12) and females (n = 12), ranging from 41 to 65 years of age. Relatively high-(0.15 Hz-0.40 Hz) and low-frequency (0.01 Hz-0.15 Hz) components of HRV were computed using spectral analysis. Poincaré parameters of each heart rate time series were considered as nonlinear features. The mean heart rate markedly differed between gender groups including both right-and left-sided seizures. High-frequency heart rate power and the low-frequency/high-frequency ratio increased in the pre-ictal phase of both male and female groups (p < .01), but men showed more increase especially in right-sided seizures. The standard deviation ratio, SD2/SD1, of pre-ictal phase was greater in males than females (p < .01). High-frequency spectral power and parasympathetic activity were higher in the female group with both right-and left-sided seizures. Men showed a sudden increase in sympathetic activity in the preictal phase, which might increase the risk of cardiovascular disease in comparison to women. These complementary findings indicate the need to account for gender, as well as localization in HRV analysis.

show abstract

EKG abnormalities in children and adolescents with symptomatic temporal lobe epilepsy

Abstract: Cardiovascular dysregulation is common during temporal lobe CPSs in children. These results confirm a right hemispheric lateralization of sympathetic cardiac control.

Cited by 97 publications

References 24 publications

Cortical lateralization and cardiac autonomic control. Insights from insular stroke and epilepsy

Cortical lateralization and cardiac autonomic control. Insights from insular stroke and epilepsy

Vigabatrin

Gender-Related Differences in Heart Rate Variability of Epileptic Patients

Contact Info

Product

Resources

About