Autonomic Dysfunction in Epileptic Patients

Year 2018, Volume: 9 Issue: 2, 76 - 80, 13.06.2018

Gökhan Özer

https://doi.org/10.5799/jcei.433809

Abstract

Objective: To investigate autonomic symptoms in different types of epilepsy in comparison to

control subjects. To observe whether autonomic symptoms cause possible morbidity and

mortality and to make a preliminary remedy

Patients and Methods: A retrospective chart review was conducted for 28 patients diagnosed

with epilepsy including 18 patients with complex partial epilepsy (CPE) and 10 patients with

primary generalized epilepsy (PJE). Their autonomic symptoms were assessed using the

COMPASS-31 questionnaire in comparison to a control group of 18 subjects.

Results: No statistically significant differences were found in autonomic dysfunction symptoms

between patients with CPE and patients with PJE. However, constipation and insomnia which

autonomic symptoms were statistically significantly more common in epileptic patients

compared to the control group.

Conclusions: It is important to recognize and watch out for symptoms of autonomic dysfunction

in patients with epilepsy. We believe that awareness for these symptoms is essential both to

reduce associated disability and develop specific treatment strategies and to predict sudden

unexpected death in epileptic patients.

Keywords

Epilepsy, autonomic dysfunction

References

• 1. Baysal Kıraç L. Otonomik belirtili nöbeti olan olgularda elektrofizyolojik verilerin ve otoantikorların araştırılması (Yan dal uzmanlık tezi). İstanbul: İstanbul Üniversitesi İstanbul Tıp Fakültesi; 2015.
• 2. Moseley B, Bateman L, Millichap JJ, Wirrell E, Panayiotopoulos CP. Autonomic epileptic seizures, autonomic effects of seizures, and SUDEP. Epilepsy Behav. 2013;26:375-85.
• 3. Miller WR, Young N, Friedman D, Buelow JM, Devinsky O. Discussing sudden unexpected death in epilepsy (SUDEP) with patients: Practices of health-care providers. Epilepsy Behav. 2014; 32: 38-41.
• 4. Ramachandran Nair R, Jack SM, Strohm S. SUDEP: To discuss or not? Recommendations from bereaved relatives. Epilepsy Behav. 2016; 56: 20-5.
• 5. Butler IJ, Lankford JE, Hashmi SS, Numan MT. Biogenic amine metabolism in juvenile neurocardiogenic syncope with dysautonomia. Ann Clin Transl Neurol. 2014;1:251-7.
• 6. Wadhwania R, Butler I, Hashmi S, Numan M, Lankford J. Dysautonomia: Retrospective study of amino acids, cytokines and neurotransmitter metabolites. Ann Neurol. 2016;80:S299.
• 7. Gordon N. Reflex sympathetic dystrophy. Brain Dev 1996;18:257-62.6. Guidelines for epidemiologic studies on epilepsy. Commission on Epidemiology and Prognosis, International League Against Epilepsy. Epilepsia. 1993;34(4):592-6.
• 8. Devinsky O. Effects of seizures on autonomic and cardiovascular function. Epilepsy Curr. 2004;4:43-46.
• 9. Sletten DM, Suarez GA, Low PA, Mandrekar J, Singer W. COMPASS 31: a refined and abbreviated Composite Autonomic Symptom Score. Mayo Clin Proc. 2012;87:1196-201.
• 10. Ravat SH, Bhatti AA, Shah MV, Muzumdar DP, Ravat SH. Ictal asystole: A rare cardiac manifestation of temporal lobe epilepsy, treated with epilepsy surgery. Ann Indian Acad. Neurol. 2017;20:55-7.
• 11. Duble SN, Thomas SV. Sudden unexpected death in epilepsy. Indian J Med Res. 2017;145:738-45.
• 12. Zijlmans M, Flanagan D, Gotman J. Heart rate changes and ECG abnormalities during epileptic seizures: Prevalence and definition of an objective clinical sign. Epilepsia. 2002;43:847-54.
• 13. Mukherjee S, Tripathi M, Chandra PS, et al. Cardiovascular autonomic functions in well-controlled and intractable partial epilepsies. Epilepsy Res. 2009; 85: 261-9.
• 14. Sathyaprabha TN, Satishchandra P, Netravathi K, Sinha S, Thennarasu K, Raju TR. Cardiac autonomic dysfunctions in chronic refractory epilepsy. Epilepsy Res. 2006;72:49-56.
• 15. Sevcencu C, Struijk JJ. Autonomic alterations and cardiac changes in epilepsy. Epilepsia. 2010;51:725-37.