Harnod Tomor, Yang Cheryl C H, Hsin Yue-Loong, Shieh Kun-Ruey, Wang Pen-Jung, Kuo Terry B J
Department of Neurosurgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
Seizure. 2008 Jun;17(4):297-301. doi: 10.1016/j.seizure.2007.09.002. Epub 2007 Oct 30.
Repetitive seizures can alter the regulation of cardiac activity by the autonomic nervous system (ANS), and ANS dysregulation is thought to be associated with higher morbidity and mortality in epileptic patients, especially from sudden unexpected death. Few studies of interictal dysregulation of cardiac activity in children with epilepsy have been performed. In this study we characterize heart rate variability (HRV) in children with refractory generalized epilepsy.
Fifteen male and 15 female children, average age = 10.9+/-0.6 years, all with refractory generalized epilepsy were enrolled into the study group. A control group consisted of 15 males and 15 females with average age = 10.6+/-0.6 years. A lead I ECG was recorded for 5 min in the interictal period during daylight hours from each subject while awake. Frequency-domain analysis of HRV was performed using a non-parametric method of fast Fourier transformation. Changes of HRV were categorized into high frequency power (HF; 0.15-0.45 Hz), which represented vagal regulation, and low frequency power (LF; 0.04-0.15 Hz). LF/(HF+LF) expressed in normalized units (LF%) was considered to mirror sympathetic regulation.
There were significant reductions in RR, LF, and HF in the study group when compared to controls. There was no significant difference in LF% between the two groups.
We postulate that the lower HRV in our patients results from parasympathetic or vagal reduction. This suggests that decreased HRV in epileptic children occurs by a different mechanism than in adults with epilepsy.
反复癫痫发作可改变自主神经系统（ANS）对心脏活动的调节，且ANS调节异常被认为与癫痫患者较高的发病率和死亡率相关，尤其是与意外猝死有关。很少有关于癫痫患儿发作间期心脏活动调节异常的研究。在本研究中，我们对难治性全身性癫痫患儿的心率变异性（HRV）进行了特征描述。
15名男性和15名女性儿童，平均年龄=10.9±0.6岁，均为难治性全身性癫痫，被纳入研究组。对照组由15名男性和15名女性组成，平均年龄=10.6±0.6岁。在白天清醒时，从每个受试者记录5分钟的I导联心电图发作间期。使用快速傅里叶变换的非参数方法对HRV进行频域分析。HRV的变化分为高频功率（HF；0.15 - 0.45Hz），代表迷走神经调节，和低频功率（LF；0.04 - 0.15Hz）。以归一化单位表示的LF/（HF + LF）（LF%）被认为反映交感神经调节。
与对照组相比，研究组的RR、LF和HF显著降低。两组之间的LF%没有显著差异。
我们推测我们患者较低的HRV是由副交感神经或迷走神经减少所致。这表明癫痫儿童HRV降低的机制与癫痫成人不同。
