Assessing epilepsy-related autonomic manifestations: Beyond cardiac and respiratory investigations

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology Pub Date : 2023-04-01 DOI:10.1016/j.neucli.2023.102850

Rosalie Marchal , Sylvain Rheims

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引用次数: 2

Abstract

The Autonomic Nervous System (ANS) regulates many critical physiological functions. Its control relies on cortical input, especially limbic areas, which are often involved in epilepsy. Peri-ictal autonomic dysfunction is now well documented, but inter-ictal dysregulation is less studied. In this review, we discuss the available data on epilepsy-related autonomic dysfunction and the objective tests available. Epilepsy is associated with sympathetic-parasympathetic imbalance and a shift towards sympathetic dominance. Objective tests report alterations in heart rate, baroreflex function, cerebral autoregulation, sweat glands activity, thermoregulation, gastrointestinal and urinary function. However, some tests have found contradictory results and many tests suffer from a lack of sensitivity and reproducibility. Further study on interictal ANS function is required to further understand autonomic dysregulation and the potential association with clinically-relevant complications, including risk of Sudden Unexpected Death In Epilepsy (SUDEP).

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评估癫痫相关的自主神经表现：超越心脏和呼吸系统研究

自主神经系统（ANS）调节许多关键的生理功能。它的控制依赖于皮层的输入，尤其是边缘区域，这通常与癫痫有关。发作期自主神经功能障碍现在已经有了很好的记录，但发作期自律失调的研究较少。在这篇综述中，我们讨论了癫痫相关自主神经功能障碍的可用数据和可用的客观测试。癫痫与交感-副交感神经失衡和向交感优势的转变有关。客观测试报告了心率、压力反射功能、大脑自动调节、汗腺活动、体温调节、胃肠和泌尿功能的变化。然而，一些测试发现了相互矛盾的结果，许多测试缺乏灵敏度和再现性。需要对发作间期ANS功能进行进一步研究，以进一步了解自主神经失调及其与临床相关并发症的潜在关联，包括癫痫猝死（SUDEP）的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurophysiologie Clinique/Clinical Neurophysiology 医学-临床神经学

CiteScore

5.20

自引率

3.30%

发文量

审稿时长

60 days

期刊介绍： Neurophysiologie Clinique / Clinical Neurophysiology (NCCN) is the official organ of the French Society of Clinical Neurophysiology (SNCLF). This journal is published 6 times a year, and is aimed at an international readership, with articles written in English. These can take the form of original research papers, comprehensive review articles, viewpoints, short communications, technical notes, editorials or letters to the Editor. The theme is the neurophysiological investigation of central or peripheral nervous system or muscle in healthy humans or patients. The journal focuses on key areas of clinical neurophysiology: electro- or magneto-encephalography, evoked potentials of all modalities, electroneuromyography, sleep, pain, posture, balance, motor control, autonomic nervous system, cognition, invasive and non-invasive neuromodulation, signal processing, bio-engineering, functional imaging.