ECG-CHANGES IN EPILEPSY PATIENTS

Objectives - To investigate the frequency of ECG abnormalities suggest ive of myocardial ischaemia in patients with severe drug resistant epi lepsy and without any indication of previous cardiac disease, assuming that these changes may be of significance far the group of epileptic patients with sudden unexpected death. Material and methods - Twelve p atients with medically intractable epilepsy were investigated with sim ultaneous long ECG and EEG recordings while attending either epilepsy surgery investigational procedures or the investigational programme fo r diagnostic purposes, and one while having an episode of status epile pticus. Results - The ECG recording failed in 1 patient, This patient had chest pain and minor yet morphologically conspicuous changes in th e EGG, suggestive of myocardial infarction. He died in heart arrest, E ight epilepsy patients had episodes of ST segment depression in the EC G, many of which coincided with video- and EEG documented epileptic se izures, Two patients experiencing simple partial seizures and 1 patien t experiencing absence seizures had no ST segment depressions in the E GG. One patient had an episode of status epilepticus secondary to brai n damage and no ST segment deviation was seen during the ECG recording which continued until 3 h before the patient died. Conclusion - Patie nts with severe drug resistant epilepsy have episodes of ST segment ch anges, some of which are closely related to epileptic seizures. Furthe r studies are needed to confirm the present results and to investigate the nature of these changes and document the effect of prophylactic t reatment with cardioactive drugs to reduce the risk of sudden death.