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Neurology 2002;58:636-638
© 2002 American Academy of Neurology
Brief Communications

Ictal heart rate differentiates epileptic from non-epileptic seizures

Christian Opherk, MD; and Lawrence J. Hirsch, MD

From the Department of Medicine (Dr. Opherk), University of Heidelberg, Heidelberg, Germany; and Comprehensive Epilepsy Center (Dr. Hirsch), Columbia University, New York, NY.

Address correspondence and reprint requests to Dr. Lawrence J. Hirsch, Columbia University Comprehensive Epilepsy Center, Neurological Institute of New York, Box NI-135, 710 W. 168th St., New York, NY 10032; e-mail: ljh3{at}columbia.edu

Video-EKG-EEG recordings of 67 epileptic seizures and 38 psychogenic nonepileptic seizures were reviewed. Ictal heart rate (HR) was higher during and after epileptic seizures for both convulsive and nonconvulsive spells (p < 0.01). When analyzing quiet staring spells separately, it was possible to identify which spells were epileptic in origin with a positive predictive value of 97% by using a cutoff of a >=30% increase in HR over baseline. It was concluded that documenting an increase in HR during a spell of unresponsiveness usually can distinguish between epileptic and psychogenic causes.




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