Işik Uğur, Ayabakan Canan, Tokel Kürşat, Ozek Memet M
Department of Pediatrics, Division of Pediatric Neurology, Acibadem University, Istanbul, Turkey.
Pediatr Int. 2012 Feb;54(1):27-31. doi: 10.1111/j.1442-200X.2011.03453.x. Epub 2011 Oct 30.
The aim of this study was to determine electrocardiographic changes in children during seizures.
We assessed heart rate changes, RR intervals and QT changes during 47 seizures in children. Consecutive QT and RR intervals were measured for 60 s before the seizures, during the seizures and 60 s after the seizures during video electroencephalography monitoring.
There were 47 seizures in 18 patients. Five patients had generalized seizures and 13 patients had focal seizures. Twelve patients were male. The mean age during monitoring was 10.1 years (range 4 months-19 years). Ictal tachycardia was seen in every seizure. No ictal bradycardia was noted. There was only one dropped beat in a patient. The mean ictal heart-rate-corrected QT (QTc) interval was significantly higher than the postictal measurements (P= 0.005). Mean ictal QTc variation tended to increase during seizures and then decreased below the pre-ictal measurements in the postictal period. However these changes were statistically insignificant (P > 0.05). RR variance was significantly decreased during seizures compared to the postictal period and the standard deviation of the RR intervals was significantly decreased in the ictal period compared to the pre-ictal period (P= 0.014 and P= 0.001, respectively).
Tachycardia is the main finding in seizures in children. Ictal bradycardia and cardiac arrhythmias are very rare despite being more frequent in adults with seizures.
本研究的目的是确定儿童癫痫发作期间的心电图变化。
我们评估了儿童47次癫痫发作期间的心率变化、RR间期和QT变化。在视频脑电图监测期间，于癫痫发作前60秒、发作期间及发作后60秒测量连续的QT和RR间期。
18例患者共发生47次癫痫发作。5例为全身性发作，13例为局灶性发作。12例为男性。监测期间的平均年龄为10.1岁（范围4个月至19岁）。每次癫痫发作均可见发作期心动过速。未观察到发作期心动过缓。仅1例患者出现1次漏搏。发作期心率校正QT（QTc）间期的平均值显著高于发作后测量值（P = 0.005）。发作期平均QTc变化在癫痫发作期间趋于增加，然后在发作后期降至发作前测量值以下。然而，这些变化无统计学意义（P>0.05）。与发作后期相比，癫痫发作期间RR方差显著降低，与发作前期相比，发作期RR间期标准差显著降低（分别为P = 0.014和P = 0.001）。
心动过速是儿童癫痫发作的主要表现。尽管发作期心动过缓和心律失常在成人癫痫患者中更常见，但在儿童中非常罕见。
