Key result
Idiopathic epilepsy in pediatric patients was associated with cardiac autonomic dysfunction, with 44% of patients showing moderate and 4% showing severe dysfunction on clinical reflex tests.
Why the study?
Do pediatric patients with idiopathic epilepsy have altered cardiovascular autonomic functions compared to healthy controls?
Case-Control (n=75)
Do pediatric patients with idiopathic epilepsy have altered cardiovascular autonomic functions compared to healthy controls?
Pediatric patients with epilepsy frequently exhibit cardiac autonomic dysfunction, which appears related to the epilepsy itself.
May signal arrhythmia vulnerability in pediatric epilepsy; hypothesis-generating and should not yet alter screening or management.
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.
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El-Sayed et al. (2007) conducted a case-control in Idiopathic epilepsy (n=75). Idiopathic epilepsy vs. Control subjects was evaluated on Cardiovascular autonomic functions (clinical reflex tests, HRV, and catecholamine excretion). Idiopathic epilepsy in pediatric patients was associated with cardiac autonomic dysfunction, with 44% of patients showing moderate and 4% showing severe dysfunction on clinical reflex tests.
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