A study on cardiovascular autonomic reflexes and thyroid hormones profile in epileptic children

Abstract EN

Sudden unexpected death is more common among epileptic patients, where epileptogenic discharge is associated with autonomic nervous system dysfunction that results in cardiac dysrhythmias.

Also, there is complex interaction between endocrine system, epilepsy and antiepileptic drugs as epilepsy per se may affect the hormonal balance and the hormones may alter the seizures activity particularly thyroid hormones.

This work was performed to demonstrate the changes in cardiovascular autonomic reflexes (CVR) function and plasma thyroid hormones profile in epileptic children.

There was normal interictal basal heart rate, blood pressure, autonomic CVR response and serum T^ and T levels in de novo patients.

A significant interictal reduction of basal heart rate and diastolic blood pressure was found in the treated patients (by carbamazepine and polytherapy of carbamazepine and valproate, respectively).

Also, there was a significantly ameliorated autonomic CVR response such as heart rate response to Valsalva's maneuver, to deep breathing, and to standing as well as postural blood pressure (PBP) changes in the treated epileptic children.

However, these changes in CVR responses were still within normal range exccpt PBP response was abnormally decremented.

This autonomic CVR dysfunction was accompanied by significant reduction of serum levels of total T and that attenuate their permissive actions for the circinating catecholamines and may aggravate the risk of autonomic CVR dysfunction.

In conclusion, the results of our study suggest that cardiovascular autonomic reflexes and thyroid function, may be affected in epileptic children as a result of chronicity of epilepsy and/or antiepileptic therapy.

The severity of autonomic CVR dysfunction was increased in monotherapy treated patients particularly carbamazepine.