P01.4 Cardiac autonomic dysfunction in West syndrome

Abstract

Background: West syndrome is an age-dependent epileptic encephalopathy. Autonomic changes are increasingly being recognized in patients with epilepsy: cardiac autonomic function is mediated by sympathetic and parasympathetic efferent activity to the heart and can provide information on the functional state of the autonomic nervous system. Methods: Cardiac autonomic function was evaluated in 13 patients with West syndrome by measuring heart rate variability during 5minute epochs of ECG in wake, stage 2 and slow wave sleep. In 5 patients who developed subsequently another type of epilepsy, a second evaluation was performed after 3 years of follow-up. Results: Results showed a lower heart rate in stage 2 sleep in patients with West syndrome. Spectral components did not show significant differences compared to age matched controls at the moment of presentation. After follow-up of 3 years we were able to demonstrate higher low frequency (LF), lower high frequency (HF) and a higher LF/HF ratio during slow wave sleep. Conclusion: This study shows a lower heart rate in patients presenting with West syndrome, already at the onset of the syndrome, even before treatment. After follow-up of only 3 years of epilepsy, chronic autonomic changes appear in the spectral components of heart rate variability.