RHYTHM AND STRUCTURAL DISORDERS OF THE HEART IN PATIENTS WITH PRIMARY DIAGNOSIS OF IDIOPATHIC EPILEPSY

Introduction: Cardiac abnormalities relate idiopathic epilepsy in several ways: Cardiac disease is the most common cause of sudden unexplained death in epilepsy. Some of epileptic syndromes have syncope as one of their major presentations. Syncope can lead to epileptic seizure and might be caused by epileptic seizure. Differentiation between syncope and seizure might be very difficult, which leads to diagnostic and therapeutic errors. Methods: 101 patients, with primary diagnosis of idiopathic epilepsy were evaluated in this descriptive study. Comprehensive evaluations including precise physical examination, electrocardiography, echocardiography and 24-hour holter monitoring were performed for each patient. Our population was subdivided in two categories: patients with cardiac disease and those without cardiac disease based on investigatory findings. Results: 24 patients (23.8%) had cardiac disease. The mean age was 34.4±19 years in patients with cardiac disease and 24.3±11 years in patients without cardiac disease. The mean age of onset of epilepsy was 24.5±22 years in patients with cardiac disease and 15.9±10 years in patients without cardiac disease. The mean duration of treatment with antiepileptic drugs was 71±22 months in patients with cardiac disease and 64±10 months in patients without cardiac disease. In 56.1% of patients without cardiac disease, seizure had been controlled excellently with antiepileptic drugs. 34.2% had good control, 7.9% had acceptable control, and 1.8% had unacceptable control. In patients with cardiac disease 27.3% had excellent control, 50% had good control, 18.2% had acceptable control and 4.5% had unacceptable control. Conclusion: These data suggest that in patients with cardiac disease either a significant percent had syncope as the cause of their symptoms or the etiology of their true seizures had been their cardiac disease. Appropriate cardiac interventions eliminated symptoms in five patients.