Abstract
The aimof the study was to investigate vegetative maintenance of the activity and state of systemic hemodynamics in patients with a first time, non-traumatic epileptic seizure during a tilt table test (TTT).Materials and methods. TTT was performed in 42 patients with absence of seizures and 78 patients having experienced unprovoked seizures. A control group included 70 patients with non-epileptic seizures with transient loss of consciousness (TLC), defined as syncope. The control group included 38 people without episodes of loss of consciousness in their medical history. The parameters of hemodynamics and heart rate variability (HRV) were investigated at all stages of the test.Results. In patients with absence of seizures, initial sympathicotonia was recorded along with a decrease in ergotropic activation in orthostasis. In patients with unprovoked seizures, a hypersympathicotonic response to the orthostatic test was detected in combination with impaired vagal overshoot in the clinostatic phase of the test. In patients with TLC, evidence of vegetative insufficiency in the vertical position was identified, with the indicators going back to the background values in the horizontal position.Conclusion. The revealed features of vegetative regulation in patients with absence of seizures and unprovoked seizures will allow to differentiate the mechanism of the first-time epileptic seizure more accurately.
Highlights
In patients with absence of seizures, initial sympathicotonia was recorded along with a decrease in ergotropic activation in orthostasis
In patients with unprovoked seizures, a hypersympathicotonic response to the orthostatic test was detected in combination with impaired vagal overshoot in the clinostatic phase of the test
The revealed features of vegetative regulation in patients with absence of seizures and unprovoked seizures will allow to differentiate the mechanism of the first-time epileptic seizure more accurately
Summary
Öåëüþ ðàáîòû ÿâèëîñü èçó÷åíèå âåãåòàòèâíîãî îáåñïå÷åíèÿ äåÿòåëüíîñòè è ñîñòîÿíèÿ ñèñòåìíîé ãåìîäèíàìèêè ó ïàöèåíòîâ ñ âïåðâûå âîçíèêøèìè íåòðàâìàòè÷åñêèìè ýïèëåïòè÷åñêèìè ïðèñòóïàìè ïðè ïðîâåäåíèè ïàññèâíîé îðòîñòàòè÷åñêîé ïðîáû (ÏÎÏ). ÏÎÏ ïðîâåëè ó 42 ïàöèåíòîâ ñ àáñòèíåíòíûìè è 78 íåñïðîâîöèðîâàííûìè ýïèëåïòè÷åñêèìè ïðèïàäêàìè. Ó ïàöèåíòîâ ñ àáñòèíåíòíûìè ïðèïàäêàìè ðåãèñòðèðîâàëàñü èñõîäíàÿ ñèìïàòèêîòîíèÿ â ñî÷åòàíèè ñî ñíèæåíèåì ýðãîòðîïíîé àêòèâàöèè â îðòîñòàçå. Ó ïàöèåíòîâ ñ íåñïðîâîöèðîâàííûìè ïðèïàäêàìè âûÿâëåíà ãèïåðñèìïàòèêîòîíè÷åñêàÿ ðåàêöèÿ ïðè îðòîñòàòè÷åñêîé íàãðóçêå â ñî÷åòàíèè ñ íàðóøåíèåì âàãàëüíîãî ïåðåðåãóëèðîâàíèÿ â êëèíîñòàòè÷åñêîé ôàçå ïðîáû. Âûÿâëåííûå îñîáåííîñòè âåãåòàòèâíîé ðåãóëÿöèè ó ïàöèåíòîâ ñ àáñòèíåíòíûìè è íåñïðîâîöèðîâàííûìè ïðèïàäêàìè ïîçâîëÿò ñ áîëüøåé íàäåæíîñòüþ äèôôåðåíöèðîâàòü ìåõàíèçì âïåðâûå âîçíèêøåãî ýïèëåïòè÷åñêîãî ïðèñòóïà â êîìïëåêñíîé îöåíêå ñ äðóãèìè êëèíèêîàíàìíåñòè÷åñêèìè äàííûìè. Àâòîðû çàÿâëÿþò îá îòñóòñòâèè ôèíàíñèðîâàíèÿ ïðè ïðîâåäåíèè èññëåäîâàíèÿ. Âàðèàáåëüíîñòü ñåðäå÷íîãî ðèòìà è ñîñòîÿíèå ñèñòåìíîé ãåìîäèíàìèêè ó âçðîñëûõ ñ âïåðâûå âîçíèêøèì íåòðàâìàòè÷åñêèì ýïèëåïòè÷åñêèì ïðèñòóïîì ïðè îðòî-êëèíîñòàòè÷åñêîé íàãðóçêå.
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