Evaluation of autonomic nervous system functions by using tilt table test and heart rate variability in epileptic children

Authors : Azad REDJEPOV, Sinem ALTUNYUVA USTA, Yuksel YILDIRIM, Figen AKALIN

Pages : 87-92

Doi:10.5472/marumj.1244552

View : 8 | Download : 3

Publication Date : 2023-01-31

Article Type : Research Paper

Abstract :Objective: The value of head-up tilt test insert ignore into journalissuearticles values(HUTT); for differential diagnosis of epilepsy and the autonomic nervous system functions in epileptic children using heart rate variability insert ignore into journalissuearticles values(HRV); are studied. Patients and Methods: The study group consisted of 16 children with idiopatic/criptogenic epilepsy and 12 controls. Heart rate, PR interval, corrected QT insert ignore into journalissuearticles values(QTc); interval, QT and QTc dispersion were calculated using 12-lead electrocardiogram insert ignore into journalissuearticles values(ECG);, HRV analysis was performed using the Holter recordings obtained both during HUTT and throughout the day. Time domain parameters, standard deviation of all RR intervals insert ignore into journalissuearticles values(SDNN);, the standard deviation of mean NN intervals in five-minutes recording insert ignore into journalissuearticles values(SDANN);, mean standard deviation of NN intervals in five-minutes recordings insert ignore into journalissuearticles values(SDNNi);, root mean square of successive differences insert ignore into journalissuearticles values(RMSSD);, count divided by the total number of all NN intervals insert ignore into journalissuearticles values(pNN50); and frequency domain parameters low frequency insert ignore into journalissuearticles values(LF);, high frequency insert ignore into journalissuearticles values(HF);, lowfrequency/ high-frequency ratio insert ignore into journalissuearticles values(LF/HF); were calculated in both and compared between the two groups. Results: Head-up tilt test was positive in 4 epileptic children insert ignore into journalissuearticles values(25%);, none of controls were positive. The heart rate of the patients were higher than the controls insert ignore into journalissuearticles values(p=0.015);. LF/HF ratio in 24-hour Holter recordings, were significantly lower insert ignore into journalissuearticles values(1.13±0.6, 1.83±0.7 respectively, p=0.002);; the SDANN during HUTT insert ignore into journalissuearticles values(28.7±20.2, 18.2 ± 19.9 respectively, p=0.024); were significantly higher in the patients than the controls. Conclusion: Head-up tilt test positivity is frequent in epileptic children, and cannot be used in differential diagnosis. HRV calculated both from 24 hour Holter recordings and Holter recordings under orthostatic stress were impaired in favour of parasympathetic system in epileptic children.
Keywords : Epilepsy, Syncope, Head up tilt test, Heart rate variability, Autonomous nervous system, Arrhythmia