Abstracts

Rationale: Rationale: To profile peak ictal vital signs (iVS) during epileptic seizures (ES). Methods: Methods: 96 consecutive, adult patients received a definitive diagnosis of ES or non-epileptic seizures (NES) during video-EEG monitoring (VEM) between 4/2010-4/2011. Heart rate (HR), oxygen saturation (SaO₂), and systolic and diastolic blood pressure (BP) were obtained at baseline on admission and during an ictus. A secondary analysis to assess the impact of motor semiology was performed. Student t-test, Fischer's Test, Wilcoxon Test (p=<0.05) and linear regression provided statistical correlation. Results: Results: Forty-six ES and 50 NES patients had no difference in baseline VS. iVS deviated from baseline in all metrics. iVS did not differ across ES types except in during generalized motor seizures where iHR was higher than focal seizures with or without consciousness (p<0.0001 and p=0.002). ES exhibited a higher iHR (p=0.02) and lower SaO₂ (p=0.003) than NES. Systolic and diastolic BP did not differ between ES and NES (p=0.9 and p=0.6). In ES, the change in iHR was inversely correlated with reduction in iSaO₂ (p=0.003). In NES, iHR was directly correlated to S-BP (p<0.0001), but not iSaO₂ (p=0.8). Conclusions: Conclusions: iHR elevation is associated with iSaO₂ reduction during ES and correlated with motor involvement. This iHR-iSaO₂ relationship in ES supports the concept of a respiratory-cardiac dysfunction associated with sudden unexplained death in epilepsy. Peak iVS deviation underscores the safety risk for both ES and NES patients.