Electrocardiographic and oximetric changes during partial complex and generalized seizures

Brian D. Moseley, Elaine C Wirrell, Katherine C Nickels, Jonathan N. Johnson, Michael John Ackerman, Jeffrey Britton

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Significant autonomic changes occur during seizures and may be related to sudden unexplained death in epilepsy (SUDEP). Accordingly, we performed a study to determine the prevalence of heart rate, QTc, and oximetric changes during seizures and analyzed their association with SUDEP risk factors. We analyzed 218 seizures from 76 patients. Ictal sinus tachycardia occurred in 57% of seizures and was associated with ≥3 failed AEDs (p=0.001), generalized seizures (p<0.001), and normal brain MRI (p=0.04). Ictal sinus bradycardia was rare, occurring in 2% of seizures. Ictal bradycardia was associated with seizure clustering (p=0.028) and reported history of ≥50 seizures/month (p=0.01). Depending on the correction formula utilized for calculating QTc, clinically significant ictal QTc prolongation (≥460. ms for children ≤13 years, ≥470. ms for males age >13, and ≥480. ms for females age >13) occurred in 4.8-16.2% of seizures, while ictal QTc prolongation ≥500. ms occurred in 2.9-16.2%. Ictal QTc shortening ≤340. ms was observed in 3.8-4.8% of seizures. Ictal hypoxemia occurred in 25% of seizures and was associated with normal MRI (p=0.01), longer seizure duration (p=0.049), and ictal tachycardia (p=0.003). Such findings may have implications for understanding the pathogenesis of SUDEP.

Original languageEnglish (US)
Pages (from-to)237-245
Number of pages9
JournalEpilepsy Research
Volume95
Issue number3
DOIs
StatePublished - Aug 2011

Fingerprint

Seizures
Stroke
Sudden Death
Epilepsy
Sinus Tachycardia
Tachycardia
Heart Rate

Keywords

  • Epilepsy
  • Hypoxemia
  • QTc
  • SUDEP
  • Tachycardia

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Electrocardiographic and oximetric changes during partial complex and generalized seizures. / Moseley, Brian D.; Wirrell, Elaine C; Nickels, Katherine C; Johnson, Jonathan N.; Ackerman, Michael John; Britton, Jeffrey.

In: Epilepsy Research, Vol. 95, No. 3, 08.2011, p. 237-245.

Research output: Contribution to journalArticle

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