Interictal cardiovascular autonomic responses in patients with temporal lobe epilepsy.
OBJECTIVE
To measure interictal cardiovascular autonomic functions in patients with either refractory or well-controlled temporal lobe epilepsy (TLE).


METHODS
For autonomic assessment, heart rate variation during normal and deep breathing, Valsalva maneuver, and tilting were measured in 19 patients with chronic refractory TLE, 19 patients with well-controlled TLE, and 38 age- and sex-matched healthy control subjects. Blood pressure responses to tilting and isometric work also were evaluated.


RESULTS
Heart-rate (HR) variation during normal breathing (p = 0.006) and tilting (p = 0.043) was lower in patients with refractory TLE than in control subjects. Heart-rate response to tilting (p = 0.036) was also lower in patients with well-controlled TLE than in control subjects. Blood-pressure responses showed no differences between the patients and the control subjects. Patients taking carbamazepine (CBZ) medication had decreased HR responses to deep breathing (p = 0.046) and to tilting (p = 0.014) compared with the control subjects.


CONCLUSIONS
Refractory TLE seems to be associated with dysfunction of the cardiovascular autonomic regulation, manifesting as impaired HR responses to certain stimuli. Interictal autonomic dysfunction is seen in patients with well-controlled TLE as well, but it may be more evident in patients with refractory epilepsy. CBZ medication may also be associated with altered autonomic cardiac control.
Ansakorpi
H
H
Department of Neurology, University of Oulu, Finland. hanna.ansakorpi@epthky.fi
Korpelainen
J T
JT
Suominen
K
K
Tolonen
U
U
Myllylä
V V
VV
Isojärvi
J I
JI
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001794:Blood Pressure; D002319:Cardiovascular System / Q000503:physiopathology; D016022:Case-Control Studies; D004833:Epilepsy, Temporal Lobe / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D018475:Head-Down Tilt; D006339:Heart Rate; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012119:Respiration; D014636:Valsalva Maneuver
D000927:Anticonvulsants