Heart rate analysis differentiates dialeptic complex partial temporal lobe seizures from auras and non-epileptic seizures

Oliveira, Gisele R. de; Gondim, Francisco de Assis Aquino; Hogan, Robert; Rola, Francisco H.

doi:10.1590/s0004-282x2007000400003

Cited by 19 publications

(32 citation statements)

References 12 publications

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“…This finding could be the result of the self-perception (body awareness) of an imminent complex partial TLS, which was not fully developed subsequently, since ictal tachycardia was present in each individual (all) dialeptic complex partial TLS 14 .…”

Section: Resultsmentioning

confidence: 96%

“…We have previously demonstrated that dialeptic complex partial TLS (which is not associated with significant motor changes) is characteristically accompanied by tachycardia (100% of the events) 14 . Since increased motor activity could not be the culprit for the tachycardia, it is likely that it was due to the activation of components of the central autonomic network.…”

Section: Resultsmentioning

confidence: 99%

“…The events were classified according to the degree of ictal motor activity in severe, moderate and mild/absent. Part of this study has been reported in abstract form elsewhere 10 .…”

mentioning

confidence: 99%

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Movement-induced heart rate changes in epileptic and non-epileptic seizures

Oliveira

Gondim

Hogan

et al. 2009

Arq. Neuro-Psiquiatr.

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-Heart rate changes are common in epileptic and non-epileptic seizures. Previous studies have not adequately assessed the contribution of motor activity on these changes nor have evaluated them during prolonged monitoring. We retrospectively evaluated 143 seizures and auras from 76 patients admitted for video EEG monitoring. The events were classified according to the degree of ictal motor activity (severe, moderate and mild/absent) in: severe epileptic (SE, N=17), severe non-epileptic (SNE, N=6), moderate epileptic (ME, N=28), moderate non-epileptic (MNE, N=11), mild epileptic (mE, N=35), mild non-epileptic (mNE, N=33) and mild aura (aura, N=13). Heart rate increased in the ictal period in severe epileptic, severe non-epileptic, moderate epileptic and mild epileptic events (p<0.05). Heart rate returned to baseline levels during the post ictal phase in severe non-epileptic seizures but not in severe epileptic patients. Aura events had a higher baseline heart rate. A cut-off of 20% heart rate increase may distinguish moderate epileptic and mild epileptic events lasting more than 30 seconds. In epileptic seizures with mild/absent motor activity, the magnitude of heart rate increase is proportional to the event duration. Heart rate analysis in seizures with different degrees of movement during the ictal phase can help to distinguish epileptic from non-epileptic events.KEy WordS: epileptic seizures, heart rate, movement, non-epileptic seizures.alterações da frequência cardíaca induzidas pelo movimento em crises epilépticas e não-epilépticas resumo -Alterações da frequência cardíaca são comuns em crises epilépticas e não-epilépticas. Estudos prévios não avaliaram adequadamente a contribuição da atividade motora nas alterações da frequência cardíaca, e as crises não foram estudadas durante monitoração prolongada. No presente estudo avaliamos retrospectivamente 143 crises de 76 pacientes admitidos para monitoração com vídeo-EEG no Hospital da Universidade de Saint Louis. As crises foram classificadas de acordo com o grau de atividade motora (severa, moderada e leve/ausente) em: epiléptica grave (EG, N=17), não-epiléptica grave (NEG, N=6), epiléptica moderada (EM, N=28), não epiléptica moderada (NEM, N=11), epiléptica leve (EL, N=35), não-epiléptica leve (NEL, N=33), e aura, N=13. A frequência cardíaca aumentou no período ictal nas crises epilépticas graves, não epilépticas graves, epilépticas moderadas, epilépticas leves (p<0,05). A frequência cardíaca apresentou tendência a retornar aos níveis basais durante o período pós ictal nas crises não epilépticas graves, mas não nas crises epilépticas graves. As auras apresentaram frequência cardíaca basal aumentada. Um limiar de 20% no aumento da frequência cardíaca pode diferenciar eventos epilépticos moderados de eventos epilépticos leves com duração maior que 30 segundos. Em crises epilépticas com atividade motora leve ou ausente, a magnitude do aumento da frequência cardíaca é proporcional à duração do evento. A análise da frequência cardíaca em crises com difere...

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

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Movement-induced heart rate changes in epileptic and non-epileptic seizures

Oliveira

Gondim

Hogan

et al. 2009

Arq. Neuro-Psiquiatr.

Self Cite

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“…The ictal heart rate is higher and the ictal heart rate increase is more rapid in epilepsy than in PNES. 83,84 Interictal heart rate variability parameters show abnormalities among patients with PNES but do not help to distinguish between patients with PNES and those with epilepsy. 85,86 Unlike that seen in epileptic seizures, the heart rise increase in PNES is usually commensurate with the physical activity involved in the seizure, 87 suggesting differences in mechanisms underlying the change in heart rate.…”

Section: Pnesmentioning

confidence: 99%

Functional Neuroanatomy and Neurophysiology of Functional Neurological Disorders (Conversion Disorder)

Voon¹,

Cavanna²,

Coburn³

et al. 2016

JNP

131

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Much is known regarding the physical characteristics, comorbid symptoms, psychological makeup, and neuropsychological performance of patients with functional neurological disorders (FNDs)/conversion disorders. Gross neurostructural deficits do not account for the patients' deficits or symptoms. This review describes the literature focusing on potential neurobiological (i.e. functional neuroanatomic/neurophysiological) findings among individuals with FND, examining neuroimaging and neurophysiological studies of patients with the various forms of motor and sensory FND. In summary, neural networks and neurophysiologic mechanisms may mediate "functional" symptoms, reflecting neurobiological and intrapsychic processes. J Neuropsychiatry Clin Neurosci 2016; 28:168-190; doi: 10.1176/appi.neuropsych.14090217 Functional neurological disorders (FNDs; or psychogenic neurological symptoms), also known as conversion disorder, are a classic neuropsychiatric disorder, existing in the border between neurology and psychiatry. Unexplained neurological symptoms are common, occurring in up to one-third of patients in neurological outpatient clinics.1 Relative to disorders such as Parkinson's disease, FND is associated with similar levels of disability and physical quality of life with poorer mental health quality of life. 2 The prognosis is poor, with a recent reviewshowing that up to 40% of patients with FND report similar or worse outcomes at 7-year follow-up. 3 Given the frequency, consequences, prognosis, and burden, FND has been called a "crisis for neurology." 4 Despite this, FND is poorly understood. In the last decade, an increasing number of studies have focused on underlying neurobiological mechanisms. FND is defined in DSM-5 as the presence of one or more symptoms of altered voluntary or sensory function, with clinical findings providing evidence of incompatibility between the symptom and recognized neurological or medical conditions.5 The DSM-5 diagnosis differs from that of the DSM-IV diagnosis of conversion disorder by adding the criterion of incorporating physical diagnostic features and by relegating to the accompanying text the criteria requiring (a) an association with psychological stressors and (b) the exclusion of malingering or factitious disorder to make the diagnosis. DSM-5 FND diagnosis criteria now allow for potential greater interrater reliability, making them appropriate for research studies and greater compatibility with specialtyspecific diagnoses including psychogenic movement disorder (PMD) and psychogenic nonepileptic seizures (PNES). 6The putative biopsychosocial mechanisms underlying FND are complex and have been extensively reviewed.7 Our review focuses on the physiological mechanisms that may underlie FND and does not specifically focus on the extensive literature on the antecedents of early childhood experiences and temperament (Figure 1). At the outset, regarding the proposed model, we acknowledge that predisposing factors for functional neurological symptoms are not limited to genetics, te...

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“…The concurrent recording of ECG during vEEG is essential. Ictal heart rate is higher and the ictal heart rate increase is more rapid in epilepsy than in PNES (Donati et al, 1996;Opherk & Hirsch, 2002;de Oliveira et al, 2007). Unlike that seen in ES, the heart rate increase in PNES is usually commensurate with the physical activity involved in the seizure (Reinsberger et al, 2012).…”

Section: Psychiatric Diagnosis (Dsm-iv-tr/dsm-5 and Icd-10 Criteria)mentioning

confidence: 99%

Minimum requirements for the diagnosis of psychogenic nonepileptic seizures: A staged approach

et al. 2013

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SUMMARYAn international consensus group of clinician-researchers in epilepsy, neurology, neuropsychology, and neuropsychiatry collaborated with the aim of developing clear guidance on standards for the diagnosis of psychogenic nonepileptic seizures (PNES). Because the gold standard of video electroencephalography (vEEG) is not available worldwide, or for every patient, the group delineated a staged approach to PNES diagnosis. Using a consensus review of the literature, this group evaluated key diagnostic approaches. These included: history, EEG, ambulatory EEG, vEEG/monitoring, neurophysiologic, neurohumoral, neuroimaging, neuropsychological testing, hypnosis, and conversation analysis. Levels of diagnostic certainty were developed including possible, probable, clinically established, and documented diagnosis, based on the availability of history, witnessed event, and investigations, including vEEG. The aim and hope of this report is to provide greater clarity about the process and certainty of the diagnosis of PNES, with the intent to improve the care for people with epilepsy and nonepileptic seizures.

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Heart rate analysis differentiates dialeptic complex partial temporal lobe seizures from auras and non-epileptic seizures

Cited by 19 publications

References 12 publications

Movement-induced heart rate changes in epileptic and non-epileptic seizures

Movement-induced heart rate changes in epileptic and non-epileptic seizures

Functional Neuroanatomy and Neurophysiology of Functional Neurological Disorders (Conversion Disorder)

Minimum requirements for the diagnosis of psychogenic nonepileptic seizures: A staged approach

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