Heart rate changes and ECG abnormalities during epileptic seizures: Prevalence and definition of an objective clinical sign
Heart rate changes and ECG abnormalities during epileptic seizures: Prevalence and definition of an objective clinical sign
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DOI：
10.1046/j.1528-1157.2002.37801.x
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发表时间：
2002-08-01
期刊：
影响因子：
5.6
通讯作者：
Gotman, J
中科院分区：
文献类型：
--
作者：
Zijlmans, M;Flanagan, D;Gotman, J
目的：确定癫痫发作期间心率变化和ECG异常的患病率，并确定与首次电图和临床体征相比心率变化的时间。方法：回顾性分析81例难治性癫痫患者的281次癫痫发作，均行长时间视频脑电图和双导心电图检查。与心电图和临床癫痫发作相比，确定心率变化的性质和时间。分析发作期（包括发作前1分钟和发作后3分钟）的心律失常、传导和复极异常。心脏异常的危险因素进行了研究，使用参数和非参数statistics.Results：有至少10次/分钟，在73%的癫痫发作（93%的患者）的心率增加，这最经常发生在癫痫发作。在23%的癫痫发作（49%的患者）的速率增加之前的电图和临床发作。26%的癫痫发作（44%的患者）中发现ECG异常。1例患者心搏停止30秒。癫痫发作持续时间长，心电图异常的发生率增加。未发现其他危险因素。结论：心率变化频繁发生，并且发生在最早的心电图或临床变化的时间前后甚至之前。这种变化可以明确癫痫发作的时间，并且特定的频率模式可能对癫痫诊断和自动癫痫检测有用。心电图异常经常发生，并在同一个病人的几个癫痫发作重复。
Purpose: To determine the prevalence of heart rate changes and ECG abnormalities during epileptic seizures and to determine the timing of heart rate changes compared to the first electrographic and clinical signs. To assess the risk factors for the occurrence of ECG abnormalities.Methods: We analyzed retrospectively 281 seizures in 81 patients with intractable epilepsy who had prolonged video-EEG and two-channel ECG. The nature and timing of heart rate changes compared to the electrographic and clinical seizure onset was determined. The ictal period (including one minute preictally and three minutes postictally) was analyzed for cardiac arrhythmias, conduction and repolarization abnormalities. Risk factors for cardiac abnormalities were investigated using parametric and non-parametric statistics.Results: There was an increase in heart rate of at least 10 beats/minute in 73% of seizures (93% of patients) and this occurred most often around seizure onset. In 23% of seizures (49% of patients) the rate increase preceded both the electrographic and the clinical onset. ECG abnormalities were found in 26% of seizures (44% of patients). One patient had an asystole for 30 seconds. Long seizure duration increased the occurrence of ECG abnormalities. No other risk factor was found.Conclusions: Heart rate changes occur frequently and occur around the time or even before the earliest electrographic or clinical change. The change can clarify the timing of seizure onset and the specific rate pattern may be useful for seizure diagnosis and for automatic seizure detection. ECG abnormalities occur often and repeatedly in several seizures of the same patient.