The Difference in Heart Rate Change between Temporal and Frontal Lobe Seizures during Peri-ictal Period

BACKGROUND AND PURPOSE Heart rate (HR) change is easily seen in seizures. Tachycardia is frequently seen in temporal lobe epilepsy (TLE), rather than extra temporal lobe epilepsy (XTLE). We report the difference in the HR pattern between TLE and frontal lobe epilepsy (FLE) during peri-ictal period. METHODS The ECG data, collected during EEG monitoring, was used. To compare the HR pattern between FLE and TLE, we investigated the baseline HR, maximum HR, seizure onset to peak HR, HR change, and the time return to baseline. RESULTS A total of 198 seizures (FLE was 115, TLE was 83) were included in this study. The baseline HR (in TLE, 74.9 ± 17.2 and in FLE, 70.7 ± 11.5 bpm), there was no difference between two groups. But the mean duration of the increased HR was more prolonged in TLE group (93.8 ± 54.9 seconds) than the FLE group(39.0 ± 21.4 seconds) (p < 0.001), the time to peak HR of the TLE group (135.1 ± 19.1 seconds) was higher than FLE group (119.3 ± 19.7 seconds) (p = 0.027), and the HR change of the TLE group (60.0 ± 26.3 bpm) was more prominent than that of the FLE group (22.8 ± 26.2 seconds) (p < 0.001). Furthermore, a longer duration of HR increase was seen in that of the TLE group than FLE group. CONCLUSIONS The HR change of the TLE group was more prominent and prolonged than that of the FLE group. Therefore, the HR change can be a pattern that differentiates TLE from FLE.