Seizures may prompt autonomically mediated changes in heart period. He
art period variability (HPV) is a sensitive tool for quantification of
autonomic control over the cardiac cycle. We used analysis of HPV to
evaluate changes in tine time and frequency domain autonomic regulatio
n of heart period during seizure activity in 44 seizures from 12 patie
nts with epilepsy: 16% of seizures were associated with changes in hea
rt rate and variability preceding behavioral and surface electroenceph
alographic (EEG) onset. Patients with consecutive partial seizures had
variable HPV changes. Seizures of left-sided EEG onset were associate
d with no change or a decrease in the power of the 0.2- to 0.4-Hz band
, whereas seizures of right-sided EEG onset were associated with no ch
ange or a decrease in the power of the 0.04- to 0.12-Hz band. We belie
ve that time- and frequency-domain analysis of HPV may provide valuabl
e information about the temporal and spatial onset of seizure activity
. Additional study using invasive EEG recordings will be needed to eva
luate the reliability of HPV to lateralize or localize seizure foci.