Ictal Heart Rate Differentiates Epileptic from Non-Epileptic Seizures.
Abstract number :
2.110
Submission category :
Year :
2001
Submission ID :
240
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
C.H. Opherk, MD, University of Heidelberg, Heidelberg, Germany; L.J. Hirsch, MD, Columbia Comprehensive Epilepsy Center, Coulmbia University, New York, NY
RATIONALE: Psychogenic non-epileptic seizures are a challenging diagnostic problem. Ictal heart rate (HR) might help to differentiate them from epileptic seizures.
METHODS: We reviewed CCTV-EEG recordings of 36 epileptic and 29 non-epileptic unresponsive staring spells.
RESULTS: Epileptic staring spells led to a significantly higher ictal relative HR (p[lt]0.001) compared to non-epileptic events. Using a cut-off of a 30% increase in HR from baseline, epileptic spells could be diagnosed correctly with a positive predictive value of 97%, negative predictive value of 82%, sensitivity of 83%, and specificity of 96%. None of the non-epileptic staring spells were associated with an absolute ictal HR higher than 140 bpm.
CONCLUSIONS: Although video/EEG is still required for definitive diagnosis, simply checking a patient[scquote]s pulse during a spell of unresponsiveness can usually distinguish between an epileptic and psychogenic non-epileptic etiology.