Autonomic Cardiac Changes in Temporal Lobe Epilepsy

Abstract

Epilepsy is the most common neurologic disorder affecting people of all ages. Up to 3% of the population will suffer epilepsy at some point in their lives. Morbidity and mortality are significant problems for patients (Chang and Lowenstein, 2003). Altered autonomic heart function is not uncommon in epileptic patients and may increase the risk of sudden unexpected death in epilepsy (Smithson et al. , 2014). Clinical evaluation of autonomic nervous system in patients with epilepsy is so important because it may help in distinguishing a group of people at greater risk of SUDEP (Sevcencu C. & Struijk J. , 2010). QTc is an indicator of cardiac repolarization. Periictal and interictal ECG changes in different types of epilepsy were found in up to 60% of epileptic patients and these findings are variable including QT, QTc and PR abnormalities of various degrees. This finding suggests that the effect of epilepsy on the heart is not only at the time of seizure but also in between seizures. (Nei, 2009). Heart-rate variability (HRV) is a widely used parameter for assessment of autonomic cardiac regulation. Decreased HRV indicates impaired autonomic heart control and is a predictor of an increased risk of sudden unexpected death in epilepsy (SUDEP) (Sztajzel, 2004). The present study was carried out to evaluate the interictal cardiovascular autonomic function among the patients with TLE and to relate the findings to the characteristics of the epilepsy disorders.