Assessment of autonomic nervous system in patients with epilepsy in the interictal state. A pilot study.

BACKGROUND AND PURPOSE: Dysfunction of the autonomic nervous system often accompanies partial and generalized epileptic seizures. In some epileptic patients dysfunction of the autonomic nervous system is also present in the interictal state. Cardiovascular autonomic disturbances are possibly associated with the pathogenesis of sudden unexpected death in people with epilepsy. The aim of the study was to evaluate the autonomic nervous system in patients with epilepsy in the interictal state and to assess the clinical usefulness of applied methods.

MATERIAL AND

METHODS

The study was done in 21 patients with epilepsy (mean age: 35.9 +/-10.7 years; mean duration of the disease: 16.7 +/-14 years). The evaluation of the autonomic nervous system was made using a questionnaire, cardiovascular reflex tests (Ewing's battery) and neurophysiological method (sympathetic skin response).

RESULTS

Abnormal score of the questionnaire was present in 57.1% of patients. Cardiovascular autonomic neuropathy (ł 2 abnormal tests of Ewing's battery) was diagnosed only in 1 patient. Abnormal sympathetic skin response was found in 33.3% of patients. Duration of the disease influenced the results of Ewing's battery only.

CONCLUSIONS

Autonomic dysfunction revealed by cardio- vascular tests is present uncommonly in patients with epilepsy in the interictal state. The questionnaire is a screening method whose result should be confirmed by other tests. The value of sympathetic skin response in diagnosis of dysautonomia in epilepsy needs further studies.