Sensitivity of Heart Rate Change as an Index of Ictal Onset of Seizures Occurring during Sleep.
Abstract number :
1.090
Submission category :
Year :
2001
Submission ID :
2906
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
T.J. Long, Diagnostic Neurology, Wake Forest University Baptist Medical Center, Winston-Salem, NC; M.F. Brown; C. Cabe; L.S. Quinlivan; C.A. O'Donovan, Neurology, Wake Forest University Baptist Medical Center, Winston-Salem, NC
RATIONALE: Determining seizure onset can be difficult during scalp VideoEEG. During sleep, this can be even more complex due to a number of factors. We sought to investigate if heart rate change may be a useful index for determining seizure onset during sleep.
METHODS: 28 seizures occurring during Stage 2 sleep in 12 patients undergoing VideoEEG(VEEG)were analysed to determine the relationship of heart rate change to EEG seizure onset. The presence or absence of arousal prior to seizure onset and its effect on heart rate was also analysed.
RESULTS: Arousals preceded 50% of seizures occurring from stage 2 sleep. Heart rate increase preceded EEG seizure onset in 65% of the seizures in which an arousal occurred before the seizure, and in 50 % of seizures without a preceding arousal. These arousals in Stage 2 sleep did not cause a significant change in heart rate and occurred on average about 18 seconds before seizure.
CONCLUSIONS: Increases in heart rate may be the first indicator of seizure onset during sleep and appears to be independent of the occurrence of arousals. The absence of heart rate change with arousals and their occurrence preceding only half of the seizures. This suggests that they are not an behavioral index of seizure onset during sleep when assessing the relationship of EEG onset to clinical onset of seizure. Larger numbers are needed to study the influence of seizure lateralization, EEG seizure pattern and other factors on ictal heart rate cahnge in sleep seizures.
Support: Supported by a Developmental Technology Grant for heart rate research.