Document Detail


Non-invasive assessment of cardioregulatory autonomic functions in children with epilepsy.
MedLine Citation:
PMID:  17511845     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We aimed to evaluate the interictal cardiovascular autonomic functions in pediatric patients with idiopathic epilepsy, both partial and generalized. MATERIALS AND METHODS: The study included 25 patients with idiopathic epilepsy and 50 control subjects. Patients underwent five standardized clinical cardiovascular reflex autonomic tests [resting heart rate (HR), HR response to deep breathing and to Valsalva maneuver, the 30:15 ratio of HR response to standing, and blood pressure response to standing], as well as a 12 lead surface electrocardiogram. Heart rate variability (HRV) was tested via 24-h Holter monitoring and the time domain parameters (SDNN, PNN50, rMSDD) were assessed. Excretion of vanillyl mandelic acid and metanephrine was measured in 24-h urine collection. RESULTS: Clinical reflex autonomic tests showed mild dysfunction in 8%, moderate dysfunction in 44% and severe dysfunction in 4% of patients. The HRV parameter, SDNN, was reduced in all age groups, while rMSDD and PNN50 were reduced only in the older age group. Metanephrine levels were significantly reduced in the patients group. Patients with uncontrolled epilepsy had a significantly higher frequency of autonomic dysfunction as assessed by clinical scoring. CONCLUSION: Cardiac autonomic dysfunction is not uncommon in pediatric patients with epilepsy. Altered cardiovascular regulation seems to be related to the epilepsy itself rather than to the characteristics of the disorder.
Authors:
H L El-Sayed; A A Kotby; H Y Tomoum; E S El-Hadidi; S E El Behery; A M El-Ganzory
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta neurologica Scandinavica     Volume:  115     ISSN:  0001-6314     ISO Abbreviation:  Acta Neurol. Scand.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-21     Completed Date:  2007-07-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370336     Medline TA:  Acta Neurol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  377-84     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Faculty of Medicine, Ain Shams University, 10 El-Nagah Street, El-Nozha, Cairo 11361, Egypt.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Aging / physiology
Arrhythmias, Cardiac / diagnosis,  etiology,  physiopathology
Autonomic Dysreflexia / diagnosis,  etiology,  physiopathology
Autonomic Nervous System / physiopathology*
Autonomic Nervous System Diseases / diagnosis,  etiology*,  physiopathology*
Cardiovascular System / innervation,  physiopathology*
Catecholamines / metabolism
Child
Death, Sudden, Cardiac / etiology
Epilepsy / complications*,  physiopathology*
Female
Heart / innervation,  physiopathology
Humans
Male
Metanephrine / urine
Vanilmandelic Acid / urine
Chemical
Reg. No./Substance:
0/Catecholamines; 5001-33-2/Metanephrine; 55-10-7/Vanilmandelic Acid

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