Clinical And Electrophysiological Studies On The Relationship Between Epilepsy And Cardiac Arrhythmia

Objective:Through video electroencephalography(EEG)and electrocardiogram(ECG)analysis during epilepsy patients at attack stage and intermediate stage,to find out whether the abnormal discharge in EEG and different types of seizures will affect the ECG activity and then lead to arrhythmia,and even cause sudden unexpected death in epilepsy(SUDEP).Material and Method:We enrolled 649 cases of diagnosed epileptics patients who had long-term video EEG + synchronous ECG monitoring(8 ~ 24h)in Tianjin Medical University General Hospital neurology clinic from January,2013 to December,2016.There were 453 epileptics in attack stage(187 cases of simple partial seizures,182 patients with complicated partial seizures,84 patients with generalized tonic clonic)and 196 patients in intermediate stage(157 patients with abnormal discharge and 39 patients without abnormal discharge).We observed the changes of EEG and synchronous ECG in all patients and analyzed the data statistically.Then we investigated the correlation between arrhythmia and different seizures types and the abnormal discharge in intermediate stage respectively.Results:157 cases of epileptic seizures in intermediate stage had abnormal discharge in VEEG.There were 40 cases of sinus tachycardia,72 cases of bradycardia,and 32 cases of atrial premature beats.While 39 cases of epileptic seizures in intermediate stage had non-abnormal discharge.There were 8 cases of sinus tachycardia,16 cases of sinus bradycardia,and 6 cases of atrial premature beats.The incidence of arrhythmia was no significant difference between abnormal discharge group and non-abnormal discharge group(P> 0.05).It was no correlation between abnormal EEG and ECG(R2 = 0.007,P = 0.238).There were 87 cases of simple partial seizures and sinus arrhythmia,42 cases of atrial and supraventricular arrhythmia,and 4 cases of QT interval prolongation and ventricular arrhythmia in simple partial seizure.There were 78 cases of sinus arrhythmia,43 cases of atrial and supraventricular arrhythmia,and 23 cases of QT interval prolonged and ventricular arrhythmia in complicated partial seizures.There were 33 cases of sinus arrhythmia,19 cases of atrial and supraventricular arrhythmia,and 15 cases of prolonged QT interval and ventricular arrhythmia in generalized tonic clonic.Besides,it was no significant difference between abnormal discharge in intermediate stage group and simple partial seizures group,between complicated partial seizures group and generalized tonic clonic group(P> 0.05),the comparison between other groups had significant difference(P <0.001).Conclusion:Patients with different type seizures had different arrhythmia: 1.Patients with simple partial seizure had little impact on the rhythm,which with or not with sinus or atrial arrhythmia;2.Patients with complex partial seizures or generalized tonic clonic had obvious impact on the rhythm,which had sinus,atrial,supraventricular or even ventricular arrhythmia.Patients diagnosed with epilepsy will have symptoms in seizures interval as follows whether they are completely controlled or not.1.Regardless of whether the epileptics' brain in attack stage abnormal discharge or not,there are no malignant arrhythmia that could cause sudden unexpected death in epilepsy occurred;2.The brain abnormal discharge in intermediate stage of epileptic seizures has no correlation with abnormal ECG activity resulting in arrhythmia.