eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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6/2020
vol. 16
 
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Neurology
abstract:
Letter to the Editor

Association between electrocardiographic and electroencephalographic changes in patients with epilepsy

Iwona Mańka-Gaca
1
,
Beata Łabuz-Roszak
2
,
Agnieszka Machowska-Majchrzak
1
,
Krystyna Pierzchała
1
,
Beata Średniawa
3
,
Sylwia Cebula
3
,
Anna Śliwińska
3
,
Ewa Markowicz-Pawlus
3
,
Agata Musialik-Łydka
3
,
Zbigniew Kalarus
3

1.
Clinical Department and Chair of Neurology in Zabrze, Medical University of Silesia, Katowice, Poland
2.
Department of Basic Medical Sciences, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, Poland
3.
Clinical Department of Cardiology, Chair of Cardiology, Congenital Heart Diseases and Electrotherapy in Zabrze, Medical University of Silesia, Katowice, Poland
Arch Med Sci 2020; 16 (6): 1472–1473
Online publish date: 2019/09/12
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Changes on electroencephalography (EEG) and electrocardiography (ECG) may occur in epileptic patients (EPs) both during epileptic seizures and in the interictal period. An abnormal EEG is not surprising in EPs. However, an abnormal ECG trace requires the exclusion of heart disease and verification of the diagnosis of epilepsy. ECG changes could also be explained by the influence of epileptic discharges on the central autonomic nervous system, the effect of antiepileptic drugs (AEDs) and the presence of genetically determined disorders of ion channel function [1–7]. Detection of ECG changes is also important because of the phenomenon of sudden unexpected death in epilepsy (SUDEP) [2].
The aim of our study was to assess the occurrence of changes on EEG and ECG in EPs. Twenty-two non-treated patients (NTPs) with newly diagnosed epilepsy before the inclusion of AEDs (mean age 36.1 ±12.1 years) and 28 patients with epilepsy treated with AEDs (TPs) for at least two years (mean age 29.6 ±8.7 years) were enrolled in the study. Subjects with cardiovascular disease, accompanying metabolic and/or electrolyte disturbances, alcohol abuse, and those on medications other than AEDs were excluded from the study.
The following tests were used in the statistical analysis: 2, Shapiro- Wilk, Student’s t-test, ANOVA, Mann-Whitney U test and Kruskal-Wallis test.
On the routine EEG, paroxysmal changes were observed in 12 NTPs (54.55%) and 14 TPs (50%); on the 24-hour EEG in 14 NTPs (63.64%) and 19 TPs (67.86%). The analysis showed a significantly higher value of 24-hour EEG for the detection of abnormal seizure activity (p = 0.02). Paro­xysmal EEG changes were related to a higher number of seizures over the last month and treatment with carbamazepine (p = 0.05).
On the resting ECG, changes were recorded in 10 NTPs (45.45%) and 11 TPs (39.29%). The following were observed: significant J-point elevation (n = 9; 18%), bradycardia (n = 5; 10%), RBBB (n = 4; 8%), shortening of QTc (n = 3; 6%), QTc prolongation (n = 1; 2%), LGL syndrome (n = 1; 2%), AV block Iº (n = 1; 2%), LBBB (n = 1; 2%) and SVEs (n = 1; 2%). In all NTPs with bradycardia (22.7%) paroxysmal EEG changes were recorded.
Changes on the 24-hour ECG were more frequent in NTPs than TPs, which did not confirm the adverse effect of AEDs on ECG as reported by many authors. The following were present: VEs (n = 28; 56%), SVEs (n = 23; 46%), bradycardia (n = 13; 26%), tachycardia (n = 9;...


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