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• W146408834 abstract "Autonomic function may help to localize and manage the epilepsies. It is likely that themechanisms of Sudden Unexpected death in Epilepsy (SUDEP) involve autonomicdisturbance and a better understanding of these might lead to measures that wouldhelp reduce the mortality in patients afflicted with epilepsy. In this thesis, I first providea comprehensive literature review of the association between epilepsy and theautonomic nervous system. I then evaluate heart rate variability and other cardiac andendocrine parameters as indices of cardiac autonomic function to test three hypothesis;1) Changes in heart rate variability (HRV), can occur in the peri-ictal period during both(a) subclinical electrographic seizures and (b) clinically overt partial seizures, and canhelp to localise and lateralise the ictal discharge. 2) Intractable epilepsy can disrupt theheart rate variability and its circadian rhythm. 3) Epileptic seizures affect the serumconcentration of the catecholamines and the electrolytes and that these changes couldimpact on the corrected QT interval. Subjects (n=207) with intractable epilepsy whowere being evaluated with video-EEG telemetry for epilepsy surgery were recruited forthis study.I found that subclinical seizures have no effect on the HRV. However, in overt partialseizures, HRV decreases, corrected QT is prolonged and plasma catecholaminesincreases. The reduction in HRV during seizures is not affected by the hemispheric orlobar location of the epileptic focus. However, in the interictal period, reduced HRVdiffers in left vs. right hemisphere, and in temporal vs. extratemporal areas. The diurnalpattern of HRV is not altered in epilepsy and the mean day HRV were significantlydifferent from mean night HRV. The reduction in HRV is also associated with thefollowing clinical factors: prolonged medical history of epilepsy, the cortical pathologyitself, the nature of the seizures, higher seizure frequency and the antiepileptic drugtreatment. The plasma electrolytes: Na, K+, Ca2+ and cardiac troponin are not affectedafter a seizure. However, plasma Mg2+ was seen to increase after a seizure. Theseabnormalities in autonomic control, particularly the reduction in HRV might be onecontributory mechanism of Sudden Unexpected Death in Epilepsy (SUDEP)." @default.
• W146408834 created "2016-06-24" @default.
• W146408834 creator A5074755249 @default.
• W146408834 date "2011-01-28" @default.
• W146408834 modified "2023-09-26" @default.
• W146408834 title "Autonomic function in epilepsy" @default.
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