The relationship between seizure onset zone and ictal tachycardia: An intracranial EEG study
The relationship between seizure onset zone and ictal tachycardia: An intracranial EEG study
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癫痫发作区与发作性心动过速之间的关系：颅内脑电图研究
DOI：
10.1016/j.clinph.2015.01.020
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发表时间：
2015
影响因子：
4.7
通讯作者：
D. Friedman
中科院分区：
文献类型：
--
作者：
M. Stefanidou;Chad E. Carlson;D. Friedman
目的癫痫发作常伴有突发性心动过速，这是与癫痫猝死（SUDEP）相关的心律失常之一。我们研究了癫痫发作的偏侧和局部与突发性心动过速发展之间的关系。方法我们确定了在18个月的时间里接受双半球颅内脑电图记录的患者。对每位患者进行2至4次连续癫痫发作检查。结果对19例患者50例癫痫发作进行分析。40例癫痫发作（80%）发展为心动过速（>比基线增加20%），但癫痫发作时的侧位不能预测其发生（p= 0.168）。起病时双侧侧侧与早期心动过速（<10 s）相关（p= 0.0208）。睡眠外发作的心动过速更快（平均19.7秒vs. 68.2秒，p= 0.0067），但警觉性状态不能预测发作后10秒内心动过速的发展。与其他颞叶组合相比，颞叶和/或眶额叶受累与心动过速相关（p= 0.0073）。结论癫痫发作侧位不能预测发作性心动过速的发生。颞叶和眶额皮质的受累，扩散到对侧半球和警觉性状态，可能决定自主神经变化的程度和速率。我们的研究结果有助于阐明癫痫发作期间的自主控制，并为未来研究SUDEP风险和癫痫发作自动检测提供潜在的应用。
ObjectivesSeizures are often accompanied by ictal tachycardia, which, when pronounced, is one of the cardiac arrhythmias associated with sudden unexpected death in epilepsy (SUDEP). We examined the relationship between the lateralization and localization of seizure onset and development of ictal tachycardia.MethodsWe identified patients who underwent bi-hemispheric intracranial EEG recording over a period of 18 months. Two to four consecutive seizures were reviewed for each patient.ResultsFifty-seizures from 19 consecutive patients were analyzed. Forty seizures (80%) developed tachycardia (>20% increase from baseline), but laterality at seizure onset did not predict its occurrence (p= 0.168).Bi-laterality at ictal onset was associated with early ictal tachycardia (<10 s) (p= 0.0208).Seizures out of sleep developed tachycardia faster (mean 19.7 s vs. 68.2 s,p= 0.0067), but the state of alertness was not predictive of the development of tachycardia within 10 s of seizure onset.Temporal and/or orbito-frontal lobe involvement was associated with tachycardia when compared to any other lobar combinations at ictal onset (p= 0.0073).ConclusionLaterality at seizure onset does not predict the occurrence of ictal tachycardia. Involvement of the temporal and orbito-frontal cortex, spread to the contralateral hemisphere and state of alertness, may define the degree and rate of autonomic changes.SignificanceOur results help clarify the autonomic control during seizures and offer potential use for future studies in SUDEP risk and automatic seizure detection.
影响因子：
14.5
作者：
Bateman, Lisa M.;Li, Chin-Shang;Seyal, Masud
通讯作者：
Seyal, Masud