[Effect of epileptic seizures on the heart rate].
BACKGROUND
Sudden death appears in 8-17% of epilepsy patients non-responding to antiepileptic therapy. Some studies suggest that the most common cause of death is seizure-related cardiac arrhythmia.


OBJECTIVE
To analyze the alteration of the heart rate six hours before and after the seizures.


METHODS
Eighteen patients suffering from focal epilepsy were examined before epilepsy surgery. Video-EEG-ECG was carried out for 2-10 days, and 32 seizures were registered. Analysis of the heart rate was based on the 5-minute-long epochs of the ECGs taken at the 5-10-15-30th minutes and at the 1-3-6th hours before and after seizures.


RESULTS
The heart rate increases (from an average of 69 beats/min to 92 beats/min, p<0.001) immediately after seizures, though significantly higher heart rate was observed 3 hours after seizures. There were no patients with severe peri-ictal bradycardia. In one of our patients, ectopic cardiac rhythm occurred after a generalized tonic-clonic seizure.


CONCLUSIONS
We can conclude that the sympathetic activity increases while the parasympathetic activity decreases after seizures. The observed alterations lasted for a long time and predict fatal arrhythmias. These suggest that sudden death in epilepsy can be induced by cardiac arrhythmias connected with epileptic seizures.
Pécsi Tudományegyetem, Neurológiai Klinika, Pécs.
Vanda
V
Tóth
László
L
Hejjel
Zsuzsanna
Z
Kalmár
András
A
Fogarasi
Tibor
T
Auer
Csilla
C
Gyimesi
Anna
A
Szucs
József
J
Janszky
D000328:Adult; D016757:Death, Sudden, Cardiac / Q000209:etiology; D004562:Electrocardiography; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000150:complications* / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013610:Tachycardia / Q000150:complications / Q000209:etiology* / Q000503:physiopathology; D014741:Video Recording