This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Background: Changes in cardiac rate and rhythm are often found in adult patients with temporal lobe epilepsy (TLE) and could be involved in the pathogenesis of sudden unexplained death (SUDEP). However, little is known about heart rate (HR) variability in pediatric patients with TLE.
Objectives: To investigate ictal and peri-ictal HR abnormalities in children and adolescents with medically refractory symptomatic TLE and to determine the influence of focus localization and laterality.
Methods: Patients younger than 18 years, with drug-resistant unilateral symptomatic TLE and presenting with at least one habitual complex partial seizure (CPS) during presurgical noninvasive video-EEG monitoring, were enrolled. Synchronous single-channel EKG recordings were analyzed during the preictal, ictal, and postictal stages.
Results: Twenty patients fulfilled the inclusion criteria. Seventy-two temporal lobe seizures (TLSs) were analyzed. Ictal tachycardia was found in 71 TLSs (98%), whereas ictal bradycardia was not observed. During preictal stages, tachycardia occurred in 20 seizures and mild bradycardia in 3. In 44 seizures (62%), tachycardia was still present >60 seconds after EEG seizure termination. Cluster analysis revealed significant differences in HR evolution depending on location and side of seizure onset: Early and high HR increase was primarily associated with right mesial TLSs.
Conclusions: Cardiovascular dysregulation is common during temporal lobe CPSs in children. These results confirm a right hemispheric lateralization of sympathetic cardiac control.
- Received December 29, 2003.
- Accepted March 11, 2004.
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
