The peculiarities of the heart rate variability and electroencephalogram changes in patients with epilepsy and cardiovascular pathology

Abstract

OBJECTIVE: Introduction: Epidemiological studies have shown that the risk of myocardial infarction and stroke is significantly higher in patients with epilepsy compared with people not suffering from epilepsy. The aim of the study was to study the parameters of HRV and EEG in patients with epilepsy to identify risk factors for cardiovascular pathology. PATIENTS AND METHODS: Materials and methods: We observed 50 patients with epilepsy without cardiovascular pathology (group 1) and 56 patients with epilepsy and cardiovascular pathology (group 2). All patients underwent clinical neurological examination, EEG, HRV and ECG assessment. RESULTS: Results: There was a significant decrease in the HRV power in both groups of patients compared with general population data (p <0.02). Also in patients of the 2nd group, TP and the power of HRV in the LF, HF ranges were significantly decreased (p <0.001). Unstrained autonomic balance was detected in 40% in the 1st group and in 6% of patients in the 2nd group (p <0.001). Each patient had as higher LF/HF ratio as less time to next seizure left (rs = 0.72; p <0.05). There was no correlation of the heart rate (ECG) and the time to the next seizure (rs = 0.12; p <0.05). A correlation of the LF / HF ratio with β rhythm (EEG) was revealed for patients in both groups (for group 1: rs = 0.48; for group 2: rs = 0.52; p <0.02). When evaluating HRV in both groups, depending on the taken AEDs, it was found that the average values of TP, VLF, LF, HF, SDNN were significantly lower in patients receiving carbamazepine when compared with patients receiving other AEDs (p<0.001). CONCLUSION: Conclusions: The factors of increased cardiovascular risk were: tense autonomic balance with a tendency to sympathicotonia, signs of a decrease in parasympathetic activity, a decrease in the TP, an increase in the representation of the EEG β-rhythm. The magnitude of the change in the frequency of the #945; rhythm in response to hyperventilation as well as the magnitude of the change in TP in orthostasis can serve as indicators of the adaptation reserve in patients with epilepsy. The development of an acute vascular event may increase the frequency of seizures and the presence of paroxysmal EEG phenomena. HRV is more informative to determine the oncoming of the seizure, than the routine ECG. Levetiracetam and lamotrigine have a more favorable effect on the autonomic balance of the heart than carbamazepine and valproic acid.