![]() Biomarkers of seizure severity derived from wearable devices. Pre-ictal heart rate changes: a systematic review and meta-analysis. Detection of epileptic seizures with a modified heart rate variability algorithm based on Lorenz plot. Jeppesen, J., Beniczky, S., Johansen, P., Sidenius, P. Comparing maximum autonomic activity of psychogenic non-epileptic seizures and epileptic seizures using heart rate variability. 2019 ESC Guidelines for the management of patients with supraventricular tachycardia The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC): developed in collaboration with the Association for European Paediatric and Congenital Cardiology (AEPC). Ictal tachycardia: the head–heart connection. Incidence, recurrence, and risk factors for peri-ictal central apnea and sudden unexpected death in epilepsy. Cardiac arrhythmias during or after epileptic seizures. Van der Lende, M., Surges, R., Sander, J. The incidence and significance of periictal apnea in epileptic seizures. Which seizure elements do patients memorize? A comparison of history and seizure documentation. Mielke, H., Meissner, S., Wagner, K., Joos, A. Classification as autonomic versus sensory seizures. Instruction manual for the ILAE 2017 operational classification of seizure types. Cessation of the pulse during the onset of epileptic fits, with remarks on the mechanism of fits. Epidemiology and pathophysiology of autonomic seizures: a systematic review. ![]() The heart of epilepsy: current views and future concepts. Shmuely, S., van der Lende, M., Lamberts, R. SUDEP and sudden cardiac death are partially overlapping entities, and the presence of pre-existing or acute cardiac comorbidities might help to differentiate between these two events. SUDEP has a spectrum of heterogeneous causes but is predominantly attributable to TCS-triggered postictal apnoea–asystole. SUDEP contrasts with self-limiting autonomic features because it typically occurs in the aftermath of a TCS, whereas ictal apnoea and ictal asystole are associated with focal - mostly temporal lobe - seizures. The key clinical expressions include flaccid falls with injuries and other signs of syncope (for example, intense pallor, jerks, stiffening and gasping) during the course of a temporal lobe seizure. Ictal asystole is the most frequent clinically relevant seizure-related arrhythmia. Ictal autonomic changes might serve as diagnostic clues, provide targets for seizure detection and help us to understand the mechanisms that underlie sudden unexpected death in epilepsy (SUDEP). In particular, we focus on presentations that are likely to contribute to SUDEP and discuss how wearable devices might help to prevent SUDEP.Īutonomic manifestations of seizures are frequent they are generally more prominent in focal seizures that originate from the temporal lobe and are particularly pronounced in focal-to-bilateral and generalized tonic–clonic seizures (TCSs). Here, we review the spectrum and diagnostic value of the mostly benign and self-limiting autonomic manifestations of epilepsy. ![]() In addition, experimental and clinical data emphasize the heterogeneity of SUDEP and its infrequent overlap with sudden cardiac death. Evidence is mounting that not all autonomic manifestations are linked to SUDEP. The presence, type and severity of autonomic features are determined by the seizure onset zone, propagation pathways, lateralization and timing of the seizures, and the presence of interictal autonomic dysfunction. ![]() Autonomic alterations are generally more prominent in focal seizures originating from the temporal lobe, demonstrating the importance of limbic structures to the autonomic nervous system, and are particularly pronounced in focal-to-bilateral and generalized tonic–clonic seizures. Epileptic networks are intimately connected with the autonomic nervous system, as exemplified by a plethora of ictal (during a seizure) autonomic manifestations, including epigastric sensations, palpitations, goosebumps and syncope (fainting). ![]()
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