title: Is elevated pre-ictal heart rate associated with secondary generalization in partial epilepsy?
abstract: BACKGROUND
  People with epilepsy are at risk for sudden unexpected death. Cardiac arrhythmia is one possible mechanism. We have studied seizure-related changes in cardiac rhythm.
  
  
  METHODS
  Video-EEG and ECG from 38 patients with epileptic seizures during long-term monitoring for investigation of partial epilepsy with ictal impairment of consciousness were obtained. Seizures were classified as either complex partial or secondarily generalized. Inter-ictal, pre-ictal, ictal and post-ictal heart rate was calculated for the first recorded seizure.
  
  
  RESULTS
  Heart rate during the pre-ictal period was higher (p=0.016) in patients with secondarily generalized seizures (n=11) compared to patients with complex partial seizures (n=27). Heart rate was also elevated during and after generalized seizures (p<0.015). Inter-ictal heart rate was not different in patients with secondary generalization compared to patients with partial seizures.
  
  
  CONCLUSIONS
  We report elevated heart rate prior to partial seizure onset in those attacks which become secondarily generalized compared to seizures which remain localized. The finding may be relevant for the understanding of sudden death in epilepsy.
authors.affiliation: Norwegian University of Science and Technology, Department of Clinical Neurosciences, Trondeim, Norway. kristian.b.nilsen@ntnu.no
authors.forename: Kristian Bernhard
authors.initials: KB
authors.lastname: Nilsen
authors.forename: Marit
authors.initials: M
authors.lastname: Haram
authors.forename: Solveig
authors.initials: S
authors.lastname: Tangedal
authors.forename: Trond
authors.initials: T
authors.lastname: Sand
authors.forename: Eylert
authors.initials: E
authors.lastname: Brodtkorb
mesh_terms: D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000503:physiopathology; D002648:Child; D003244:Consciousness Disorders / Q000209:etiology / Q000503:physiopathology; D003627:Data Interpretation, Statistical; D003645:Death, Sudden; D018450:Disease Progression; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000503:physiopathology; D004829:Epilepsy, Generalized / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000503:physiopathology*; D055815:Young Adult