Comparative study on autonomic dysfunction in idiopathic generalized epilepsy

Abstract

Objectives: Autonomic nervous system symptoms are frequently observed in patients with epilepsy. Our objective was to investigate the alterations in autonomic function in idiopathic generalized epilepsy (IGE) patients compared to age-and sex-matched Patients without Epilepsy (PwoE). Materials and Methods: Thirty patients with epilepsy who had the disease for 6 months–15 years and were controlled or partially controlled with antiepileptic medications, along with a group of healthy PwoEs, underwent Autonomic Function Tests after providing informed consent. The tests measured heart rate variability and blood pressure (BP) responses, and the results were statistically analyzed using Ewing’s and Bellavere’s criteria to classify cardiac autonomic neuropathy (CAN). Results: The two groups were demographically comparable. Abnormal breathing patterns, abnormal Valsalva ratios, abnormal hand grip test results, and abnormal BP response were more prevalent in the people with epilepsy (PwE) group than in the PwoE group, and these were statistically significant. There were 18 (60.0%) subjects in the PwE group and none in the PwoE in the definite CAN category (score 4–6). Early CAN was noted in both groups but was slightly more prevalent in the PwE group. Most patients (50.0%) were undergoing treatment for periods ranging from 1 to 2 years, and levetiracetam was the most commonly used anti-seizure medication (ASM). Valproate was associated with the highest proportion of abnormal CAN, followed by levetiracetam and phenytoin. Conclusion: This study demonstrates that patients with IGE exhibit a significantly higher prevalence of autonomic dysfunction compared to healthy PwoEs, drawing attention to the need for further investigation into the underlying mechanisms and clinical implications.