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QT interval alterations in epilepsy: A thorough investigation between epilepsy subtypes

  • Author Footnotes
    1 2015-2017 affiliation: Necmettin Erbakan University, Meram School of Medicine, Department of Neurology (Division of Clinical Neurophysiology), 9042080 Konya/TURKEY.
    Asli Akyol Gurses
    Correspondence
    Corresponding author at: Gazi University, Faculty of Medicine, Department of Neurology – Division of Clinical Neurophysiology, 06500, Besevler, Ankara, Turkiye.
    Footnotes
    1 2015-2017 affiliation: Necmettin Erbakan University, Meram School of Medicine, Department of Neurology (Division of Clinical Neurophysiology), 9042080 Konya/TURKEY.
    Affiliations
    Gazi University School of Medicine, Department of Neurology (Division of Clinical Neurophysiology), 906560 Ankara, Turkey
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  • Emine Genc
    Affiliations
    Necmettin Erbakan University, Meram School of Medicine, Department of Neurology, 9042080 Konya, Turkey
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  • Author Footnotes
    2 Current affiliation: Adnan Menderes University, School of Medicine, Department of Histology and Embriology, 909010 Aydin/TURKEY.
    Kadri Murat Gurses
    Footnotes
    2 Current affiliation: Adnan Menderes University, School of Medicine, Department of Histology and Embriology, 909010 Aydin/TURKEY.
    Affiliations
    Konya Training and Research Hospital, Cardiology Clinic, 9042080 Konya, Turkey
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  • Taylan Altiparmak
    Affiliations
    Gazi University School of Medicine, Department of Neurology (Division of Clinical Neurophysiology), 906560 Ankara, Turkey
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  • Irem Yildirim
    Affiliations
    Gazi University School of Medicine, Department of Neurology (Division of Clinical Neurophysiology), 906560 Ankara, Turkey
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  • Bulent Oguz Genc
    Affiliations
    Necmettin Erbakan University, Meram School of Medicine, Department of Neurology, 9042080 Konya, Turkey
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  • Author Footnotes
    1 2015-2017 affiliation: Necmettin Erbakan University, Meram School of Medicine, Department of Neurology (Division of Clinical Neurophysiology), 9042080 Konya/TURKEY.
    2 Current affiliation: Adnan Menderes University, School of Medicine, Department of Histology and Embriology, 909010 Aydin/TURKEY.

      Highlights

      • PWE had increased values of QTc and QTcd when compared to patients with PNESs.
      • QTc - QTcd values do not demonstrate any difference between patients with FE and GE.
      • PR interval is prolonged in PWE with left sided and extratemporal foci.

      Abstract

      Objectives

      Cardiac disturbances and rhythm abnormalities which potentially lead sudden unexpected death in epilepsy, have been extensively studied in focal epilepsies. However, studies including generalized epilepsies are scarce and it is not clear whether electrocardiogram parameters reflecting vulnerability to ventricular arrhythmias differ between these groups.

      Methods

      Medical records of patients who were followed in epilepsy department of a tertiary center between October 2015 and September 2016 were retrospectively reviewed. 66 generalized and 64 focal epilepsy patients with eligible electrophysiological data were analyzed. QTc interval, QTcd and other electrocardiographic indices were compared between patients with focal vs generalized epilepsy. Another analysis was performed in order to disclose any difference between patients with epilepsy (n:130) and psychogenic non-epileptic seizures. A two-tailed p value < 0.05 was considered significant.

      Results

      There was no difference in terms of QTc and QTcd between patients with focal and generalized epilepsy [median: 406 ms vs 404 ms, p = 0.119; and median: 46 ms vs 44 ms, p = 0.497, respectively]. However patients with epilepsy were found to have longer QTc and QTcd when compared to ones with psychogenic non-epileptic seizures (p = 0.035 and p < 0.001, respectively).

      Conclusion

      Current findings demonstrate that patients with epilepsy have longer QTc and QTcd than patients with pure psychogenic non-epileptic seizures. Since there was no difference between patients with focal and generalized epilepsy; QTc interval, QTcd and potential susceptibility to cardiac arrhythmias as a result, could be a consequence of epilepsy itself regardless of origin.

      Keywords

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