Ictal changes in parasympathetic tone: Prediction of postictal oxygen desaturation

Neurology
William SzurhajJulien De Jonckheere

Abstract

To measure changes in parasympathetic tone before, during, and after temporal seizures, and to determine whether changes in high-frequency heart rate variability are correlated with postictal oxygen desaturation. We recorded the electrocardiogram and peripheral oxygen saturation during 55 temporal lobe seizures and calculated a high-frequency variability index (HFVI) as a marker of parasympathetic tone for periods of 20 minutes (centered on seizure onset). We then compared HFVI values in seizures with and without postictal hypoxemia, and looked for correlations between HFVI changes and the risk of sudden unexpected death in epilepsy (SUDEP) (as assessed with the SUDEP-7 Inventory). Parasympathetic tone decreased rapidly at the onset of temporal lobe seizures, reached its minimum value at the end of the seizure, and then gradually returned to its preictal value. Changes in parasympathetic tone were more intense and longer-lasting in older patients with a longer duration of epilepsy. The HFVI was significantly lower during seizures with hypoxemia, and remained significantly lower 5 minutes after the end of the seizure. The change in the HFVI slope over the first 30 seconds of the seizure was predictive of postictal oxygen desatur...Continue Reading

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Citations

Mar 1, 2019·Human Brain Mapping·Florian ChouchouLaure Mazzola
Aug 30, 2019·Journal of Clinical Monitoring and Computing·P CharlierJ De Jonckheere
Nov 28, 2017·Neuropathology and Applied Neurobiology·M ThomO Devinsky
Apr 11, 2021·Neurology·William SzurhajJulien De Jonckheere

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