Determination of cardiac changes in refractory epilepsy patients during ictal period

Autonomic dysfunction and deteriotion at heart rate variability in patients with epilepsy have been demostrated in many studies. However very few studies in childhood have been made on this issue.Our study included 20 refractory epilepsy patient as study group, 20 good controlled epilepsy and 20 healthy children as control groups. There was no statiscally signifiant difference in age and gender between groups. All subjects were evaluated with Holter ECG monitorization for heart rate variability and with 12 leads ECG for QTc dispersion to asess autonomic functions. Also patients with refractory epilepsy were evaluated with holter ECG monitorization during seizures.Three sinusal taschycardia and one T wave inversion was observed during 17 seizure activity. Study group have statiscally signicant more pathologic QTc dispersion than the control groups. Heart rate variability was significantly supressed and deterioration in the parasympathetic activity was observed in the study group. Also good controlled epilepsy group had tend to the same difference between healthy group, it was not as statiscally significant as study group. Heart rate variability during and before seizures were also evaluted and increased sympathatetic activity was found.As a result we thought that deteriotion in parasympathetic activity was directly proportional with the severity of the epilepsy. It can be thought that patients with refractory epilepsy have inability to cope with increased sympathetic activity during seizures because of corrupted parasympathetic activity and this can cause to SUDEP. Perhaps heart rate variability arising prior to seizures can be used as alert for seizures in the futureKey Words: Epilepsy, Heart, SUDEP