A study of interictal cardiac autonomic functions in patients with refractory complex partial epilepsy secondary to medial temporal lobe pathology: Before and after surgery

Background: Ictal changes in heart rate, blood pressure and other autonomic functions have been described in patients with epilepsy. Autonomic cardiovascular regulatory dysfunction has been detected in patients with epilepsy by measuring cardiovascular reflex tests. 1 The resection of the anterior amygdala and hippocampal areas influences the autonomic modulation of blood pressure and heart rate as well as the baroreflex. 2 There are only a few studies about the possible interictal alterations of cardiovascular autonomic regulation and the impact of temporal lobectomy in patients with refractory medial temporal lobe epilepsy. Objectives: 1. To compare cardiac autonomic functions in patients with refractory seizures secondary to medial temporal lobe lesions, prior to epilepsy surgery and to compare them with age and sex matched controls. 2. To repeat the cardiac autonomic functions three to six months after surgery and to compare with pre operative functions. 3. Measurement of spectral analysis of heart rate variability before and after surgery Methods: Fourteen patients diagnosed to have mesial temporal lobe pathology with refractory complex partial seizures underwent cardiac autonomic function tests: deep breathing test, valsalva maneuver, orthostatic test, isometric work and spectral analysis of heart rate variability before epilepsy surgery. The results were compared with healthy age and sex matched controls. The tests were repeated 3-6