Document Detail


Cardiovascular autonomic functions in well-controlled and intractable partial epilepsies.
MedLine Citation:
PMID:  19409754     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Epilepsy is associated with imbalance of sympathetic and parasympathetic activity which may lead to sudden unexplained death in epilepsy (SUDEP). Well-controlled (WcE) and intractable epilepsy (IE) subjects may present different autonomic profiles, which can be helpful in explaining the predisposition of the latter to SUDEP. PURPOSE: To compare inter-ictal cardiovascular autonomic function in subjects with partial WcE and IE. METHODS: Thirty WcE and 31 IE subjects underwent a battery of autonomic function tests: deep breathing, Valsalva maneuver, isometric exercise, cold pressor and tilt-table. Autonomic tone was assessed by heart rate variability (HRV). Their autonomic severity score and anxiety status was also assessed. RESULTS: IE subjects had elevated low frequency component (52.0 vs. 37.6, p=0.047) and decremented high frequency component (114 vs. 397, p=0.013) of HRV and higher diastolic BP (75.62+/-9.77 vs. 68.64+/-0.43, p=0.036). In deep breathing test, they had lesser HR changes (20+/-10.18 vs. 29.68+/-11.23, p=0.007) and lower E:I (1.29+/-0.16 vs. 1.43+/-0.21, p=0.008). IE subjects had higher dysautonomia (chi square 165.0, p<0.0001). CONCLUSIONS: We observed a higher vasomotor tone, higher sympathetic tone, lower parasympathetic tone, lower parasympathetic reactivity and more severe dysautonomia in the IE subjects. Refractoriness may lead to an alteration in cardiovascular autonomic regulation, which might be a predisposing factor for SUDEP.
Authors:
Shalini Mukherjee; Manjari Tripathi; Poodipedi S Chandra; Rajeev Yadav; Navita Choudhary; Rajesh Sagar; Rafia Bhore; Ravindra Mohan Pandey; K K Deepak
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-05-05
Journal Detail:
Title:  Epilepsy research     Volume:  85     ISSN:  1872-6844     ISO Abbreviation:  Epilepsy Res.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-21     Completed Date:  2009-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703089     Medline TA:  Epilepsy Res     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  261-9     Citation Subset:  IM    
Affiliation:
Dept. of Neurology, UT Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd, Dallas, TX, United States. shalini mukherjee@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anticonvulsants / therapeutic use*
Autonomic Nervous System / physiopathology*
Blood Pressure / drug effects
Cardiovascular Physiological Phenomena*
Child
Child, Preschool
Cold Temperature / diagnostic use
Drug Resistance
Electrocardiography
Epilepsies, Partial / drug therapy*,  physiopathology*,  psychology
Female
Hand Strength / physiology
Heart Rate / physiology
Humans
Male
Middle Aged
Neuropsychological Tests
Respiratory Mechanics / physiology
Valsalva Maneuver / physiology
Young Adult
Chemical
Reg. No./Substance:
0/Anticonvulsants

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