Electrocardiographic changes in patients with refractory epilepsy

Background: Epilepsy is the second most common type of chronic neurological disease. Its diagnosis carries an excess mortality, which is 2-3 times higher than that of general population. Mortality rates are increased among patients with uncontrolled seizures. The aim of this study was to characterize the electrocardiogram (ECG) changes during pre-ictal, ictal and post-ictal states in pharmaco-resistant epilepsy patients. Materials and Methods: This retrospective study conducted by Department of Neurology and Department of Cardiology of Isfahan Medical University from September 2008 to December 2012, patients with medically refractory epilepsy who underwent standard pre-surgical assessment from Epilepsy ward of Kashani hospital in Isfahan city were recruited in this study. Results: The heart rate (HR) varied significantly throughout the record. Significant difference in HR was identified between ictal and pre-ictal periods (P = 0.000), furthermore, the difference between ictal and pre-ictal HR {mean = 63.867 +/- 0.061, P = 0.000}, ictal and post-ictal HR {mean = 38.833 +/- 0.067, P = 0.003}, and between pre- and post-ictal HR {mean = 25.033 +/- 0.089, P = 0.000}, was significant. Conclusion: ECG monitoring should be a part video-(electroencephalography) EEG monitoring to identify serious cardiac abnormalities, particularly in patients with refractory epilepsy.