Ictal heart rate increase precedes EEG discharge in drug-resistant mesial temporal lobe seizures

Giancarlo Di Gennaro, Pier Paolo Quarato, Fabio Sebastiano, Vincenzo Esposito, Paolo Onorati, Liliana G. Grammaldo, Giulio N. Meldolesi, Addolorata Mascia, Carolina Falco, Ciriaco Scoppetta, Fabrizio Eusebi, Mario Manfredi, Giampaolo Cantore

Research output: Contribution to journalArticle

Abstract

Objective: Heart rate (HR) changes, mainly tachycardia, are often observed during seizures originating from the temporal lobe. The aim of this study was to analyze the role of ictal HR changes in localizing both mesial and lateral temporal lobe epilepsy (TLE) in a group of 68 patients. The influence of the gender and the side of epilepsy on HR modulation was also evaluated. Methods: Ictal HR was recorded during prolonged Video-EEG monitoring performed in 68 patients affected by drug-resistant TLE during a non-invasive pre-surgical protocol. According to the electro-clinical correlation, obtained by video-EEG monitoring, one hundred-thirteen seizures (n=113) and one hundred-forty-four auras (n=144) were identified and included in the study. Furthermore, the electro-clinical correlation allowed the classification of all the epileptic events (seizures and auras) as having mesial or lateral origin, based on the temporal lobe seizure onset zone. Ictal HR was calculated with respect to the R-R waves, and assessed from 15 sec (s) before (T- 15) to 15 s after (T+15) the time of EEG seizure onset (T0). Results: We observed a high incidence (92%) of ictal HR increase in TLE seizures. When the ictal EEG indicated a seizure onset from the mesial temporal structures, the onset of ictal HR increase preceded by about 5 s the EEG ictal onset (SD±18.4), whereas the onset of HR increase coincided with the onset of EEG discharges (SD±14.8) when the ictal EEG indicated the onset of seizures from the lateral temporal structures. No significant differences were found between male and female patients; and between right and left TLE. Conclusions: Our findings show that ictal HR increase, preceding the onset of the EEG discharge, is associated with ictal EEG seizure pattern defining temporal lobe seizures originating from the mesial temporal lobe structures; this association suggests that the HR changes may be coupled to the functional impairment of neural circuits involved in sympathetic cardiovascular regulation, in the mesial temporal lobe structures. Further studies investigating the relationship between intracranial EEG monitoring and ECG recording are worthwhile, to confirm our results and to give further indications on the pathogenesis of ictal HR abnormalities.

Original languageEnglish
Pages (from-to)1169-1177
Number of pages9
JournalClinical Neurophysiology
Volume115
Issue number5
DOIs
Publication statusPublished - May 2004

Fingerprint

Temporal Lobe
Electroencephalography
Seizures
Heart Rate
Stroke
Temporal Lobe Epilepsy
Pharmaceutical Preparations
Epilepsy
Congenital Heart Defects
Tachycardia
Electrocardiography

Keywords

  • Epilepsy surgery
  • Heart rate
  • Presurgical evaluation
  • Temporal lobe epilepsy
  • Video EEG

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Neurology
  • Sensory Systems
  • Physiology (medical)

Cite this

Ictal heart rate increase precedes EEG discharge in drug-resistant mesial temporal lobe seizures. / Di Gennaro, Giancarlo; Quarato, Pier Paolo; Sebastiano, Fabio; Esposito, Vincenzo; Onorati, Paolo; Grammaldo, Liliana G.; Meldolesi, Giulio N.; Mascia, Addolorata; Falco, Carolina; Scoppetta, Ciriaco; Eusebi, Fabrizio; Manfredi, Mario; Cantore, Giampaolo.

In: Clinical Neurophysiology, Vol. 115, No. 5, 05.2004, p. 1169-1177.

Research output: Contribution to journalArticle

Di Gennaro, Giancarlo ; Quarato, Pier Paolo ; Sebastiano, Fabio ; Esposito, Vincenzo ; Onorati, Paolo ; Grammaldo, Liliana G. ; Meldolesi, Giulio N. ; Mascia, Addolorata ; Falco, Carolina ; Scoppetta, Ciriaco ; Eusebi, Fabrizio ; Manfredi, Mario ; Cantore, Giampaolo. / Ictal heart rate increase precedes EEG discharge in drug-resistant mesial temporal lobe seizures. In: Clinical Neurophysiology. 2004 ; Vol. 115, No. 5. pp. 1169-1177.
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title = "Ictal heart rate increase precedes EEG discharge in drug-resistant mesial temporal lobe seizures",
abstract = "Objective: Heart rate (HR) changes, mainly tachycardia, are often observed during seizures originating from the temporal lobe. The aim of this study was to analyze the role of ictal HR changes in localizing both mesial and lateral temporal lobe epilepsy (TLE) in a group of 68 patients. The influence of the gender and the side of epilepsy on HR modulation was also evaluated. Methods: Ictal HR was recorded during prolonged Video-EEG monitoring performed in 68 patients affected by drug-resistant TLE during a non-invasive pre-surgical protocol. According to the electro-clinical correlation, obtained by video-EEG monitoring, one hundred-thirteen seizures (n=113) and one hundred-forty-four auras (n=144) were identified and included in the study. Furthermore, the electro-clinical correlation allowed the classification of all the epileptic events (seizures and auras) as having mesial or lateral origin, based on the temporal lobe seizure onset zone. Ictal HR was calculated with respect to the R-R waves, and assessed from 15 sec (s) before (T- 15) to 15 s after (T+15) the time of EEG seizure onset (T0). Results: We observed a high incidence (92{\%}) of ictal HR increase in TLE seizures. When the ictal EEG indicated a seizure onset from the mesial temporal structures, the onset of ictal HR increase preceded by about 5 s the EEG ictal onset (SD±18.4), whereas the onset of HR increase coincided with the onset of EEG discharges (SD±14.8) when the ictal EEG indicated the onset of seizures from the lateral temporal structures. No significant differences were found between male and female patients; and between right and left TLE. Conclusions: Our findings show that ictal HR increase, preceding the onset of the EEG discharge, is associated with ictal EEG seizure pattern defining temporal lobe seizures originating from the mesial temporal lobe structures; this association suggests that the HR changes may be coupled to the functional impairment of neural circuits involved in sympathetic cardiovascular regulation, in the mesial temporal lobe structures. Further studies investigating the relationship between intracranial EEG monitoring and ECG recording are worthwhile, to confirm our results and to give further indications on the pathogenesis of ictal HR abnormalities.",
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T1 - Ictal heart rate increase precedes EEG discharge in drug-resistant mesial temporal lobe seizures

AU - Di Gennaro, Giancarlo

AU - Quarato, Pier Paolo

AU - Sebastiano, Fabio

AU - Esposito, Vincenzo

AU - Onorati, Paolo

AU - Grammaldo, Liliana G.

AU - Meldolesi, Giulio N.

AU - Mascia, Addolorata

AU - Falco, Carolina

AU - Scoppetta, Ciriaco

AU - Eusebi, Fabrizio

AU - Manfredi, Mario

AU - Cantore, Giampaolo

PY - 2004/5

Y1 - 2004/5

N2 - Objective: Heart rate (HR) changes, mainly tachycardia, are often observed during seizures originating from the temporal lobe. The aim of this study was to analyze the role of ictal HR changes in localizing both mesial and lateral temporal lobe epilepsy (TLE) in a group of 68 patients. The influence of the gender and the side of epilepsy on HR modulation was also evaluated. Methods: Ictal HR was recorded during prolonged Video-EEG monitoring performed in 68 patients affected by drug-resistant TLE during a non-invasive pre-surgical protocol. According to the electro-clinical correlation, obtained by video-EEG monitoring, one hundred-thirteen seizures (n=113) and one hundred-forty-four auras (n=144) were identified and included in the study. Furthermore, the electro-clinical correlation allowed the classification of all the epileptic events (seizures and auras) as having mesial or lateral origin, based on the temporal lobe seizure onset zone. Ictal HR was calculated with respect to the R-R waves, and assessed from 15 sec (s) before (T- 15) to 15 s after (T+15) the time of EEG seizure onset (T0). Results: We observed a high incidence (92%) of ictal HR increase in TLE seizures. When the ictal EEG indicated a seizure onset from the mesial temporal structures, the onset of ictal HR increase preceded by about 5 s the EEG ictal onset (SD±18.4), whereas the onset of HR increase coincided with the onset of EEG discharges (SD±14.8) when the ictal EEG indicated the onset of seizures from the lateral temporal structures. No significant differences were found between male and female patients; and between right and left TLE. Conclusions: Our findings show that ictal HR increase, preceding the onset of the EEG discharge, is associated with ictal EEG seizure pattern defining temporal lobe seizures originating from the mesial temporal lobe structures; this association suggests that the HR changes may be coupled to the functional impairment of neural circuits involved in sympathetic cardiovascular regulation, in the mesial temporal lobe structures. Further studies investigating the relationship between intracranial EEG monitoring and ECG recording are worthwhile, to confirm our results and to give further indications on the pathogenesis of ictal HR abnormalities.

AB - Objective: Heart rate (HR) changes, mainly tachycardia, are often observed during seizures originating from the temporal lobe. The aim of this study was to analyze the role of ictal HR changes in localizing both mesial and lateral temporal lobe epilepsy (TLE) in a group of 68 patients. The influence of the gender and the side of epilepsy on HR modulation was also evaluated. Methods: Ictal HR was recorded during prolonged Video-EEG monitoring performed in 68 patients affected by drug-resistant TLE during a non-invasive pre-surgical protocol. According to the electro-clinical correlation, obtained by video-EEG monitoring, one hundred-thirteen seizures (n=113) and one hundred-forty-four auras (n=144) were identified and included in the study. Furthermore, the electro-clinical correlation allowed the classification of all the epileptic events (seizures and auras) as having mesial or lateral origin, based on the temporal lobe seizure onset zone. Ictal HR was calculated with respect to the R-R waves, and assessed from 15 sec (s) before (T- 15) to 15 s after (T+15) the time of EEG seizure onset (T0). Results: We observed a high incidence (92%) of ictal HR increase in TLE seizures. When the ictal EEG indicated a seizure onset from the mesial temporal structures, the onset of ictal HR increase preceded by about 5 s the EEG ictal onset (SD±18.4), whereas the onset of HR increase coincided with the onset of EEG discharges (SD±14.8) when the ictal EEG indicated the onset of seizures from the lateral temporal structures. No significant differences were found between male and female patients; and between right and left TLE. Conclusions: Our findings show that ictal HR increase, preceding the onset of the EEG discharge, is associated with ictal EEG seizure pattern defining temporal lobe seizures originating from the mesial temporal lobe structures; this association suggests that the HR changes may be coupled to the functional impairment of neural circuits involved in sympathetic cardiovascular regulation, in the mesial temporal lobe structures. Further studies investigating the relationship between intracranial EEG monitoring and ECG recording are worthwhile, to confirm our results and to give further indications on the pathogenesis of ictal HR abnormalities.

KW - Epilepsy surgery

KW - Heart rate

KW - Presurgical evaluation

KW - Temporal lobe epilepsy

KW - Video EEG

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