Cardiorespiratory and autonomic function in epileptic seizures: A video-EEG monitoring study.

摘要: PURPOSE: Seizure-induced cardiorespiratory and autonomic dysfunction has long been recognized, growing evidence points to its implication in sudden unexpected death epilepsy (SUDEP). However, a comprehensive understanding of function the preictal, ictal, postictal periods are lacking. METHODS: We examined continuous 157 seizures (18 convulsive 139 nonconvulsive) from 70 consecutive patients who had seizure captured on concurrent video-encephalogram (EEG) monitoring polysomnography between February 1, 2012 May 31, 2017. Heart respiratory rates, heart rate variability (HRV), oxygen saturation were assessed across four distinct periods: baseline (120 s), preictal (60 s), (300 s). rates further followed for up 60 min after termination assess return baseline. RESULTS: Ictal tachycardia occurred during both nonconvulsive seizures, but maximum was higher (mean: 138.8 beats/min, 95% confidence interval (CI): 125.3-152.4) compared with 105.4 CI: 101.2-109.6; p < 0.001). Convulsive associated lower ictal minimum 0 breaths/min, 0-0) 11.0 9.5-12.6; obstructive apnea seizures. The low-frequency (LF) power band HRV among than (ratio means (ROM): 2.97, 1.34-6.60; p = 0.008). Postictal substantially prolonged, characterized by longer (median: 60.0 min, interquartile range (IQR): 46.5-60.0) 0.26 min, IQR: 0.008-0.9; For hyperventilation, 25.3 min, 8.1-60) 1.0 min, 0.07-3.2; LF (ROM: 0.33, 0.11-0.96; p = 0.043). generalized EEG suppression (PGES; n = 12) rate, increased HRV, those without (n = 6). CONCLUSIONS: Profound may explain why these carry greatest risk SUDEP.