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Published in: BMC Neurology 1/2001

Open Access 01-12-2001 | Research article

Heart rate changes during partial seizures: A study amongst Singaporean patients

Authors: Einar Wilder-Smith, Shih-Hui Lim

Published in: BMC Neurology | Issue 1/2001

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Abstract

Introduction

Studies in Europe and America showed that tachycardia, less often bradycardia, frequently accompanied partial seizures in Caucasian patients. We determine frequency, magnitude and type of ictal heart rate changes during partial seizures in non-Caucasian patients in Singapore.

Methods

Partial seizures recorded during routine EEGs performed in a tertiary hospital between 1995 and 1999 were retrospectively reviewed. All routine EEGs had simultaneous ECG recording. Heart rate before and during seizures was determined and correlated with epileptogenic focus. Differences in heart rate before and during seizures were grouped into 4 types: (1) >10% decrease; (2) -10 to +20% change; (3) 20–50% increase; (3) >50% increase.

Results

Of the total of 37 partial seizures, 18 were left hemisphere (LH), 13 were right hemisphere (RH) and 6 were bilateral (BL) in onset. 51% of all seizures showed no significant change in heart rate (type 2), 22% had moderate sinus tachycardia (type 3), 11% showed severe sinus tachycardia (type 4), while 16% had sinus bradycardia (type 1). Asystole was recorded in one seizure. Apart from having more tachycardia in bilateral onset seizures, there was no correlation between side of ictal discharge and heart rate response. Compared to Caucasian patients, sinus tachycardia was considerably less frequent. Frequency of bradycardia was similar to those recorded in the literature.

Conclusions

Significant heart rate changes during partial seizures were seen in half of Singaporean patients. Although sinus tachycardia was the most common heart rate change, the frequency was considerably lower compared to Caucasian patients. This might be due to methodological and ethnic differences. Rates of bradycardia are similar to those recorded in the literature.
Literature
1.
go back to reference Blumhardt LD, Smith PEM, Owen L: Electrographic accompaniments of temporal lobe epileptic seizures. Lancet. 1986, 10: 1051-1055. 10.1016/S0140-6736(86)91328-0.CrossRef Blumhardt LD, Smith PEM, Owen L: Electrographic accompaniments of temporal lobe epileptic seizures. Lancet. 1986, 10: 1051-1055. 10.1016/S0140-6736(86)91328-0.CrossRef
2.
go back to reference Marshall DW, Westmoreland BF, Sharbrough FW: Ictal tachycardia during temporal lobe seizures. Mayo Clin. Proc. 1983, 58: 443-446.PubMed Marshall DW, Westmoreland BF, Sharbrough FW: Ictal tachycardia during temporal lobe seizures. Mayo Clin. Proc. 1983, 58: 443-446.PubMed
3.
go back to reference Keilson MJ, Hauser A, Magrill JP: Electroencephalographic changes during Electrographic seizures. Arch Neurol. 1989, 46: 1169-1170.CrossRefPubMed Keilson MJ, Hauser A, Magrill JP: Electroencephalographic changes during Electrographic seizures. Arch Neurol. 1989, 46: 1169-1170.CrossRefPubMed
4.
go back to reference Wilder-Smith E, Wilder-Smith A: Complex partial seizures as a cause of transient cardiac arrhythmia. Schweiz Med Wochenschr. 1995, 125: 2237-2243.PubMed Wilder-Smith E, Wilder-Smith A: Complex partial seizures as a cause of transient cardiac arrhythmia. Schweiz Med Wochenschr. 1995, 125: 2237-2243.PubMed
5.
go back to reference Jay G, Leetsma J: Sudden death in epilepsy: a comprehensive review of the literature and proposed mechanisms. Acta Neurol Scand. 1981, 63 (suppl 82): 1-66. Jay G, Leetsma J: Sudden death in epilepsy: a comprehensive review of the literature and proposed mechanisms. Acta Neurol Scand. 1981, 63 (suppl 82): 1-66.
6.
go back to reference Joske DJ, Davis MJ: Sino-atrial arrest due to temporal lobe epilepsy. Aust NZJ Med. 1991, 21: 62-62.CrossRef Joske DJ, Davis MJ: Sino-atrial arrest due to temporal lobe epilepsy. Aust NZJ Med. 1991, 21: 62-62.CrossRef
7.
go back to reference Oppenheimer SM, Cechetto DF, Hachinski VC: Cerebrogenic Cardiac Arrhythmias: Cerebral Electrocardiographic Influences and Their Role in Sudden Death. Arch Neurol. 1990, 47: 513-519.CrossRefPubMed Oppenheimer SM, Cechetto DF, Hachinski VC: Cerebrogenic Cardiac Arrhythmias: Cerebral Electrocardiographic Influences and Their Role in Sudden Death. Arch Neurol. 1990, 47: 513-519.CrossRefPubMed
8.
go back to reference Reeves AL, Nollet KE, Klass DW, Sharbrough FW, So EL: The Ictal Bradycardia Syndrome. Epilepsia. 1996, 37: 983-987.CrossRefPubMed Reeves AL, Nollet KE, Klass DW, Sharbrough FW, So EL: The Ictal Bradycardia Syndrome. Epilepsia. 1996, 37: 983-987.CrossRefPubMed
9.
go back to reference Schernthaner C, Lindinger G, Poetzelberger K, Zeiler K, Baumgartner C: Autonomic epilepsy: the influence of epileptic discharges on heart rate and rhythm. Wien Klin Wochenschr. 1999, 111: 392-401.PubMed Schernthaner C, Lindinger G, Poetzelberger K, Zeiler K, Baumgartner C: Autonomic epilepsy: the influence of epileptic discharges on heart rate and rhythm. Wien Klin Wochenschr. 1999, 111: 392-401.PubMed
10.
go back to reference Devinsky O, Pacia S, Tatambhotla G: Bradycardia And Asystole Induced By Partial Seizures : A Case Report and Literature Review. Neurology. 1997, 48: 1712-1714.CrossRefPubMed Devinsky O, Pacia S, Tatambhotla G: Bradycardia And Asystole Induced By Partial Seizures : A Case Report and Literature Review. Neurology. 1997, 48: 1712-1714.CrossRefPubMed
11.
go back to reference Lim E CH, Lim SH, Wilder-Smith E: Brain seizes, heart ceases: a case of ictal asystole. J Neurol Neurosurg Psychiatry. 2000, 69: 557-559. 10.1136/jnnp.69.4.557.CrossRefPubMedPubMedCentral Lim E CH, Lim SH, Wilder-Smith E: Brain seizes, heart ceases: a case of ictal asystole. J Neurol Neurosurg Psychiatry. 2000, 69: 557-559. 10.1136/jnnp.69.4.557.CrossRefPubMedPubMedCentral
12.
go back to reference Reis DJ, Oliphant MC: Bradycardia and tachycardia following electrical stimlation of the amygdaloid region in monkey. J Neurophysiol. 1964, 27: 893-912.PubMed Reis DJ, Oliphant MC: Bradycardia and tachycardia following electrical stimlation of the amygdaloid region in monkey. J Neurophysiol. 1964, 27: 893-912.PubMed
13.
go back to reference Nashef L, Walker F, Allen P, Sander JWAS, Shorvon S, Fish DR: Apnoea and bradycardia during epileptic seizures: relation to sudden death in epilepsy. J Neurol Neurosurg Psychiatry. 1996, 60: 297-300.CrossRefPubMedPubMedCentral Nashef L, Walker F, Allen P, Sander JWAS, Shorvon S, Fish DR: Apnoea and bradycardia during epileptic seizures: relation to sudden death in epilepsy. J Neurol Neurosurg Psychiatry. 1996, 60: 297-300.CrossRefPubMedPubMedCentral
14.
go back to reference Epstein MA, Sperling MR, O'Connor MJ: Cardiac thythm during temporal lobe seizures. Neurology. 1992, 42: 50-53.CrossRefPubMed Epstein MA, Sperling MR, O'Connor MJ: Cardiac thythm during temporal lobe seizures. Neurology. 1992, 42: 50-53.CrossRefPubMed
Metadata
Title
Heart rate changes during partial seizures: A study amongst Singaporean patients
Authors
Einar Wilder-Smith
Shih-Hui Lim
Publication date
01-12-2001
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2001
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/1471-2377-1-5

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