Abstract:
OBJECTIVE:The cardiac component of risk for sudden unexpected death in epilepsy (SUDEP) and alterations in cardiac risk by vagus nerve stimulation (VNS) are not well understood. We determined changes in T-wave alternans (TWA), a proven noninvasive marker of risk for sudden cardiac death in patients with cardiovascular disease, and heart rate variability (HRV), an indicator of autonomic function, in association with VNS in patients with drug-resistant focal epilepsy. METHODS:Ambulatory 24-h electrocardiograms (N = 9: ages 29-63, six males) were analyzed. RESULTS:Mean TWA during the interictal period was 37 ± 3.1 μV (mean ± SEM) in lead V1 for nine patients monitored following implantation of the VNS system (n = 7) or battery change (n = 2). Of these, six patients also monitored prior to implantation (n = 5) or battery change (n = 1) showed abnormally high TWA levels pre-VNS (60.0 ± 4.3 μV), which were significantly reduced by 24.3 μV (to 35.7 ± 4.8 μV, p = 0.02) after VNS settings were adjusted for desired clinical response. TWA in four (67%) of the six patients was reduced in association with VNS to levels below the 47-μV cut point of abnormality. The decrease in TWA was correlated with VNS intensity (r = 0.88, p < 0.02). In addition, low-frequency HRV was reduced by 60% (805.61 ± 253.96 to 323.49 ± 102.74 msec(2) , p = 0.05) and low-to high-frequency HRV ratio by 32% (3.34 ± 0.57 to 2.26 ± 0.31, p = 0.025), indicating a change in autonomic balance in favor of parasympathetic dominance. SIGNIFICANCE:This is the first report that elevated levels of TWA in patients with drug-refractory partial-onset seizures were reduced in association with VNS, potentially by improving sympathetic/parasympathetic balance. VNS may have a cardioprotective role at stimulation settings typically used for seizure control. These findings indicate the utility of TWA for tracking improvement in cardiac status in this population.
journal_name
Epilepsiajournal_title
Epilepsiaauthors
Schomer AC,Nearing BD,Schachter SC,Verrier RLdoi
10.1111/epi.12855subject
Has Abstractpub_date
2014-12-01 00:00:00pages
1996-2002issue
12eissn
0013-9580issn
1528-1167journal_volume
55pub_type
杂志文章相关文献
EPILEPSIA文献大全abstract:PURPOSE:Epilepsy is known to result from aneurysmal subarachnoid hemorrhage (SAH). There are no population-based estimates of the absolute risk or the duration for which this risk is elevated. We have conducted a population-based study in Iceland of the risk of epilepsy after a ruptured cerebral aneurysm to address the...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.2000.tb00326.x
更新日期:2000-09-01 00:00:00
abstract::Twenty-three infants and children underwent cortical resection (n = 15) or hemispherectomy (n = 8) for intractable infantile spasms. Infantile spasms were present at the time of surgery in 17 of the 23 patients; in six, spasms had evolved to other seizure types during surgical evaluation. Children with a remote histor...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1993.tb00459.x
更新日期:1993-07-01 00:00:00
abstract::Clobazam (CLB), a 1,5-benzodiazepine, is a remarkably effective add-on drug for individual patients with refractory partial epilepsy. CLB has an excellent safety record. As with all benzodiazepines used for treating epilepsy, sedation and withdrawal effects, together with the development of tolerance, limit its useful...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/j.1528-1157.1994.tb05979.x
更新日期:1994-01-01 00:00:00
abstract:PURPOSE:Mesial temporal sclerosis (MTS) is characterized by neuronal loss in the hippocampus. Studies on experimental models and patients with intractable epilepsy suggest that apoptosis may be involved in neuronal death induced by recurrent seizures. METHODS:We searched evidence for apoptotic cell death in temporal l...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1046/j.1528-1157.2003.37402.x
更新日期:2003-06-01 00:00:00
abstract::Neurotrophic factors are involved in the survival of neurons as well as in the proliferation and differentiation of neuronal precursors. Therefore, modulating their levels in lesion areas may exert favorable effects on seizure-induced damage. However, it is unclear if damage limitation or repair may prevent epileptoge...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2010.02609.x
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:Common data elements (CDEs) are standardized questions and answer choices that allow aggregation, analysis, and comparison of observations from multiple sources. Clinical CDEs are foundational for learning health care systems, a data-driven approach to health care focused on continuous improvement of outcomes...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.16733
更新日期:2021-01-01 00:00:00
abstract::We predicted vigabatrin dosages for adjunctive therapy for pediatric patients with refractory complex partial seizures (rCPS) that would produce efficacy comparable to that observed for approved adult dosages. A dose-response model related seizure-count data to vigabatrin dosage to identify dosages for pediatric rCPS ...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.12825
更新日期:2014-12-01 00:00:00
abstract::Study of patients with temporal lobe epilepsy and generalized epilepsy revealed no overall seizure type differences, nor overall age-at-onset effects, on MMPI measures of psychopathology. However, statistically significant interactions between seizure type and age at onset were obtained on several MMPI measures, and s...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1980.tb04040.x
更新日期:1980-02-01 00:00:00
abstract::Children with malformations of cortical development represent a significant proportion of pediatric epilepsy surgery candidates. From a cohort of 40 children operated on between 1980 and 1992 with malformation of cortical development, 38 were alive and had data 10 years after surgery. Age at surgery ranged from 6 mont...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.0013-9580.2005.52504.x
更新日期:2005-04-01 00:00:00
abstract:PURPOSE:The goal of the study was to assess the health-related quality of life (HRQOL) of persons with epilepsy (PWE) by using the short form survey 36 (SF-36), to compare it with that of a control group and to detect factors influencing it. METHODS:We collected clinical and demographic data and information on health ...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.0013-9580.2004.56903.x
更新日期:2004-07-01 00:00:00
abstract:PURPOSE:To describe the semiological features of auditory aura and to assess their possible lateralizing value in partial epilepsy. METHODS:Out of a series of 8,000 patients with epilepsy, we investigated 121 cases with partial seizures in whom auditory features were the first ictal symptom. According to the dominant ...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2006.00881.x
更新日期:2006-01-01 00:00:00
abstract:PURPOSE:To evaluate relationships between self-report measures of seizure severity and health-related quality of life (HRQOL) in people with refractory localization-related epilepsy. METHODS:A sample of 340 adults enrolled in a seven-center, prospective study of resective epilepsy surgery completed baseline questionna...
journal_title:Epilepsia
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1111/j.1528-1157.2000.tb00239.x
更新日期:2000-06-01 00:00:00
abstract::An understanding of the basic principles of human inheritance patterns is necessary to appreciate the variety and complexity of genetic influences in the epilepsies. The various modes of human inheritance include single gene (mendelian), chromosomal, mitochondrial, and multifactorial/polygenic. Recent insights regardi...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1994.tb05924.x
更新日期:1994-01-01 00:00:00
abstract::The pharmacokinetics of phenylethylmalonamide (PEMA), a major metabolite of primidone, were investigated following administration of single oral doses (400 mg) to six normal subjects and six patients receiving chronic treatment with antiepileptic drugs. Peak serum PEMA levels were usually attained with 2-4 h after int...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1982.tb06196.x
更新日期:1982-06-01 00:00:00
abstract:PURPOSE:Febrile seizures (FS) are the most common type of convulsive events in children. FS are suggested to result from a combination of genetic and environmental factors. However, the pathophysiologic mechanisms underlying FS remain unclear. Using an animal model of experimental FS, it was demonstrated that hyperther...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2011.03259.x
更新日期:2011-11-01 00:00:00
abstract::Hyperthermia was induced in mature rats by immersing them in 20 cm of 45 degrees C water for 4 min. Rats were made hyperthermic once every 4 days for six exposures. A significant number had at least one convulsion by the third exposure. During the seventh exposure, 2 weeks after the sixth exposure, twice as many rats ...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1984.tb04192.x
更新日期:1984-06-01 00:00:00
abstract::Autoantibodies to surface proteins that influence neuronal excitability are increasingly found in different forms of epilepsy or encephalitis in adults, and are also beginning to be identified in children. The conditions are often refractory to traditional antiepileptic drugs. Detection of these antibodies can help to...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/j.1528-1167.2011.03224.x
更新日期:2011-10-01 00:00:00
abstract:PURPOSE:Exposure to toxic levels of organophosphorus (OP) nerve agents can lead to seizures, respiratory failure, and, if untreated, death. The cholinesterase inhibitor soman belongs to the class of OP nerve agents and can cause status epilepticus (SE) and brain damage due to neuroexcitotoxicity. In the present study, ...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2009.02478.x
更新日期:2010-08-01 00:00:00
abstract::Traditionally, control of seizures in patients with epilepsy is viewed as the most important clinical outcome. Yet, current antiepileptic drugs (AEDs) do not always achieve this. Around 30-40% of patients remain uncontrolled despite pharmacological intervention. Poor tolerability of AEDs is a large part of the problem...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/j.0013-9580.2004.455002.x
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:In CSWS (continuous spike waves during sleep) activation of spike waves during slow wave sleep has been causally linked to neuropsychological deficits, but the pathophysiologic mechanisms are still unknown. In healthy subjects, the overnight decrease of the slope of slow waves in NREM (non-rapid eye movement)...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.12576
更新日期:2014-04-01 00:00:00
abstract:PURPOSE:Previous studies have established the importance of the insular cortex and temporal lobe in cardiovascular autonomic modulation. Some investigators, based on the results of cortical stimulation response, functional imaging, EEG recordings of seizures, and lesional studies, have suggested that cardiac sympatheti...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2006.00509.x
更新日期:2006-04-01 00:00:00
abstract::5-Hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) were measured by high-performance liquid chromatography (HPLC) in lumbar cerebrospinal fluid (CSF) obtained from febrile children subdivided according to the presence or absence of convulsions. Lumbar puncture was made either early (mean time 2 h) or late...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.1990.tb06303.x
更新日期:1990-03-01 00:00:00
abstract:OBJECTIVE:Studies have found that affected individuals who believe the cause of their disorder is genetic may react in various ways, including optimism for improved treatments and pessimism due to perceived permanence of the condition. This study assessed the psychosocial impact of genetic attribution among people with...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.16352
更新日期:2019-11-01 00:00:00
abstract::Data on numbers of admissions and admission rates for all-listed and first-listed epilepsy in nonfederal short-stay hospitals are presented. These statistics are based on 232,000 hospital discharge records from a probability sample of approximately 7,000 hospitals. The patterns of admission rates for epilepsy are comp...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1981.tb04332.x
更新日期:1981-02-01 00:00:00
abstract:OBJECTIVE:Interictal spikes are a characteristic feature of invasive electroencephalography (EEG) recordings in children with refractory epilepsy. Spikes frequently co-occur across multiple brain regions with discernable latencies, suggesting that spikes can propagate through distributed neural networks. The purpose of...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.14720
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy and tolerability of antiepileptic drugs (AEDs) in elderly individuals with epilepsy. METHODS:We searched four electronic databases as well as bibliographies and conference abstracts. Published and unpublished, randomized, or quasirandomized trials reporting the use of AEDs in people ...
journal_title:Epilepsia
pub_type: 杂志文章,meta分析
doi:10.1111/epi.16068
更新日期:2019-07-01 00:00:00
abstract::Between 1929 and 1980, 284 patients with refractory nontumoral frontal lobe epilepsy (FLE) underwent operation at the Montreal Neurological Institute (MNI). We studied 39 patients (14%) who required reoperation. Mean age at the time of first operation was 18 years and at reoperation was 22 years. Clinical manifestatio...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1994.tb02914.x
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate health care expenditures among elderly patients with epilepsy in the United States. METHODS:We performed an analysis of weighted 37 738 607 US participants aged 65 years to estimate health care expenditures in the elderly with and without epilepsy using the Medical E...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.14455
更新日期:2018-07-01 00:00:00
abstract:PURPOSE:To compare the risks of fetal malformation during pregnancy associated with antiepileptic drug (AED) polytherapy and monotherapy. METHODS:Statistical analysis of malformation rate and antiepileptic drug exposure data from the Australian Register of Antiepileptic Drugs in Pregnancy, and from the literature. RE...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/j.1528-1167.2009.02336.x
更新日期:2010-05-01 00:00:00
abstract::We determined changes in serum concentrations of thyroid hormones during carbamazepine (CBZ) therapy during a 5-year prospective follow-up study of 20 patients with newly diagnosed epilepsy. In addition, we evaluated the effects of replacing CBZ with oxcarbazepine (OCBZ) in 12 male patients with epilepsy in a 6-month ...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1995.tb01619.x
更新日期:1995-08-01 00:00:00