癫痫发作的报警与预警_Journal of Epilepsy

Authors：

王薇薇 ,  吴逊

北京大学第一医院神经内科（北京 100034）;

Corresponding author：

吴逊, Email: bxtong@163.com

Keywords：

癫痫发作; 预警; 报警; 心率; 心率变异性

DOI：

10.7507/2096-0247.202203010

Video：

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癫痫是一种最常见的神经系统疾病，特点为多数发作无诱因且难以预测。发作可导致合并症，包括外伤及癫痫猝死（Sudden unexpected death in epilepsy，SUDEP），并致生活质量下降。过去20年广泛研究了发作的预警和报警，开发很多方法及设备，如头皮脑电图、颅内脑电图、肌电图、皮肤电变化、心率和心率变异性（Heart rate variability，HRV）。其中HRV是最有前景的方法。发作发放通过网络导致交感神经和副交感神经间不平衡并且改变了自主神经发放合并心率异常。过去20年用计算机方法开发了HRV的谱分析。HRV的变化早于脑电图发作和临床发作的开始。HRV可能是癫痫发作的预警和报警的指标。现在虽有很多关于癫痫的HRV算法，但是缺少标准的对于癫痫患者的方案，并且没有固定的监测模式，使之难以转化为临床实用，解决这个问题是十分重要的。总结出一个HRV评估的最低方案可用于所有癫痫患者的研究十分必要，可使HRV成为预警癫痫发作的有用工具。

Citation： 王薇薇, 吴逊. 癫痫发作的报警与预警. Journal of Epilepsy, 2022, 8(4): 320-325. doi: 10.7507/2096-0247.202203010 Copy

1.	Van de Vel A, Smets K, Wauters K et al. Automated non-EEG based seizure detection: do users have a say? Epilepsy & Behavior, 2016, 62(1): 121-128.
2.	Jeppesen J, Beniczky S, Johansen P, et al. Using Lorenz plot and cardiac sympathetic index of heart rate variability for detecting seizures for patients with epilepsy. Annu Int Cont IEEE Eng Med Biol Soc, 2014, 22(S3): 4563-4566.
3.	van Westrhenen A. De Cooman T, Lazeron RHC et al. Ictal autonomic changes as a tool for seizure detection:a systematic review. Clin Autsnomic Research, 2019, 29(2): 161-181.
4.	Kosal E, Serdaroglu A, Cilsal E, et al. Can heart rate variability in children with epilepsy be used to predict seizures? Seizure, 2014, 23(5): 357-362.
5.	Beniczky S, Jeppesen J. Nonelectroencephalography-based seizure detection. Curr Opin Neural, 2019, 32(2): 198-204.
6.	Baumgartner C, Koreen JP. Seizure detection using sealp-EEG. Epilepsia, 2018, 59(S1): 14-22.
7.	Fujwara K, Miyajima M, Yamaku wa T, et al. Epileptic seizure prediction based on multivariate statistical process control of heart rate variability feature. IEEE Trans Biomed Eng, 2016, 63(6): 1321-1332.
8.	Stirling RE, Cook MJ, Grayden DB, et al. Seizure forecasting and cyclic control of seizure. Epilepsia, 2021, 62(Suppl 1): 2-14.
9.	Qaraqe M, Ismail M, Serpedin E, et al. Epileptic seizure onset detection based on EEG and ECG data fusion. Epilepsy & Behavior, 2016, 58(1): 48-60.
10.	Jeppesen J, Beniczky S, Fuglsang-Frederiken A, et al. Detection of epileptic-seizuers by means of pauser spectrum analysis of heart rate variability: a pilot study. Technology and Health Care, 2010, 18(6): 417-426.
11.	Tomson T, Ericson M, Ihrman C, et al. Heart rate variability in patient with epilepsy. Epilepsy Research, 1998, 30(1): 77-83.
12.	Varon C, Montalto A, Janson K, et al. Interictal cardiorespiratory variability in temporal lobe and absence epilepsy in childhood. Physiol Meas. 2015, 36(4): 845-856.
13.	Liu HY, Yang Z, Meng FG, et al. Preoperative heart rate variability as predictors of vagus nerve stimulation outcome in patients with drug-resistant epilepsy. Sci Rep, 2018, 8(1): 38-56.
14.	Persson H, Kumlien E, Ericson M, et al. Preoperative heart rate variability in relation to surgery outcome in refractory epilepsy. Neurology, 2005, 65(7): 1021-1025.
15.	Eggleston KS, Olin BD, Fisher RS. Ictal tachycardia: the head-heart connection. seizure, 2014, 23(7): 496-505.
16.	Hirsch M, Altermüller D-M, Schulze-Bonhage A. Lantenies from intracranal seizure onset to ictal tachycardia: a camparison to surface EEG patterns and other clinical signs. Epilepsia, 2015, 56(10): 1639-1647.
17.	Sevcencu C, Struijk JJ. Autonomic alteration and cardiac changes in epilepsy. Epilepsia, 2010, 51(5): 725-737.
18.	Jeppesen J, Fuglsang-Frederiken A, Johansen P, et al. Seizure detection based on heart rate variability using a wearable electrocardiography device. Epilepsia, 2019, 60(10): 2105-2113.
19.	Schiecke C, Wacher M, Piper D, et al. Time-variant, frequency-selective, linear and nonlinear analysis of heart rate variability in children with temporal lobe epilepsy. IEEE Trans Biomed Eng, 2014, 61(6): 1798-1808.
20.	Dalziel DJ, Uthman BM, McGorry SP, et al. Seizure-alert dogs, a review and preliminary study. Seizuer, 2003, 12(2): 115-120.
21.	Osario I, Manly BEJ. Probability of detection of clinical seizures using heart rate changes. Seizure. 2015, 30(2): 120-123.
22.	王薇薇, 吴逊. 癫痫及癫痫发作中的心功能障碍. 中华神经科杂志, 2014, 47(3): 189-192.
23.	Rugg-Gunn FJ, Simister RJ, Squirrell M, et al. Cardiac arrhythmias in focal epilepsy: a prospective long-term study. Lancet, 2004, 364(9452): 2212-2219.
24.	Moseley BD, Nickels K, Briston J, et al. How common in ictal hypoxemia and bradyeardia in children with partial complex and generalized convulsion seizure ? Epilepsia, 2010, 51(7): 1219-1224.
25.	王薇薇, 吴逊. 癫痫自主神经发作及发作时的自主神经症状. 临床神经病学杂志, 2015, 28(4): 241-243.
26.	Toth V, Hejiel L, Fogarasi A, et al. Periictal heart rate variability analysis suggests long-term postictal autonomic disturbance in epilepsy. European J Neunol, 2010, 17(6): 780-797.
27.	Zijlmans M, Flanagan D, Gotman J. Heart rate changes and ECG abnormalities during epileptic seizure: prevalence and difinition of an objective clinical sign. Epilepsia, 2002, 43(8): 847-854.
28.	Schernthaner C, Lindinger RJ, Squirrell M, et al. Autonomic epilepsythe influence of epileptic discharges on heart rate and rhythm. Wein Klin Wochenschn, 1999, 111(10): 392-401.
29.	Myers KA, Bello-Espinosa LE, Symoneds JD, et al. Heart rate variability in epilepsy: a potential biomaker of sudden unexpected death in epilepsy risk. Epilepsia, 2018, 59(7): 1372-1380.
30.	Goit RK, Jha SK, Pant BN. Alteration of cardiac autonomic function in patients with newly diagnosed epilepsy. Physiol Reperts, 2016, 4(11): e12826: 1-5.
31.	Myers KA, Sivathamboo S, Perucca P. Heart rate variability measurement in epilepsy: How can we move from research to clinical practice? Epilepsia, 2018, 59(12): 2169-2178.
32.	Mukherjee S, Tripathi M, Chandra PS, et al. Cardiovascular autonomic function in well-controlled and intratable partial epilepsies. Epilepsy Research, 2009, 85(2-3): 261-269.
33.	Task Force of the European Sociaty of Cardiology and The North American Sociaty of Pacing and Electrophysiology. Heart rate variability standards of measurement, physiological interpretation, and clinical use. European Heart J, 1996, 17(3): 354-381.
34.	Yildiz Gu, Dogan EA, Dogan U, et al. Analysis of 24 hours rate variations in patients with epilepsy receiving antiepileptic drugs. Epilepsy & Behavior 2011, 20(2): 349-345.
35.	Behbahani S, Dabanloo NJ, Nasrabodi AM, et al. Preictal heart rate variability assessment of epileptic seizures by means of linear and non-linear analysis. Anadolu Kardiyol Derg, 2013, 13(8): 797-803.
36.	Novak VV, Reeves LA, Novak P, et al. Time-frequency mapping of R-R interval during complex partial seizures of temporal lobe origin. J Auton Nerv Syst, 1999, 77(2-3): 195-202.
37.	Baysal-Kirac L, Serbeet NG, Sahin E, et al. Analysis of heart rate variability and risk factors for SUDEP in patients with drug-resistant epilepsy. Epilepsy & Behavior, 2017, 71(1): 60-64.
38.	Persson H, Ericson M, Tomson T. Heart rate variability in patient with untreat epilepsy. Seizure, 2007, 16(6): 504-508.
39.	Brotherstone R, Mclellon A. Parasympathetic alteration during subclinical seizures. Seizure, 2012, 21(5): 391-398.
40.	Leumezen F, Schernthaner C, Lurgen S, et al. Electrocardiographic changes at the onset of epileptic seizures. Epilepeia, 2003, 44(3): 348-354.
41.	Sathyaprabha TN, Satishchandra P, Netravathi K, et al. Cardiac autonomic dysfunction in chronic refractory epilepsy. Epilepsy Research, 2006, 72(1): 49-56.
42.	Suorsa E, Korpelainen JT, Ansakorpi H, et al. Heart rate dynamics in temporal lobe epilepsy-a long-term follow-up study. Epilepsy Research, 2011, 93(1): 80-83.
43.	Harnod T, Yang CCH, Hsin Y-L, et al. Heart rate variability in patients with frontal lobe epilepsy. Seizure, 2009, 18(1): 21-25.
44.	Malarvilli MB, Mesbah M. Newborn seizure detection based on heart rate variability. IEEE Trans Biomed Eng, 2009, 56(11): 2594-2603.
45.	Jeppesen J, Beniczky C, Johansen P, et al. Comparing maximum autonomic activity of psychogenic non-epileptic seizures and epileptic seizures using heart rate variability. Seizure, 2016, 37(1): 13-19.
46.	Ponnusamy A, Margues JLB, Reuber M. Comparison of heart variability parameters during complex partial seizures and psychagenic non-epileptic seizures. Epilepsia, 2012, 53(8): 1314-1321.
47.	Harden C, Tomson T, Gloso D, et al. Practice guideline summary: Sudden unexpected death in epilepsy incidence rates and risk factors: Report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology and American Epilepsy Society. Epilepsy Currents, 2017, 17(3): 180-187.
48.	Eppinger N, Shauman R, Jokert H, et al. Ruduced heart rate variability(HRV) in victims of sudden death in epilepsy(SUDEP). Epilepsia, 2004, 45(suppl 3): 65.

1. Van de Vel A, Smets K, Wauters K et al. Automated non-EEG based seizure detection: do users have a say? Epilepsy & Behavior, 2016, 62(1): 121-128.
2. Jeppesen J, Beniczky S, Johansen P, et al. Using Lorenz plot and cardiac sympathetic index of heart rate variability for detecting seizures for patients with epilepsy. Annu Int Cont IEEE Eng Med Biol Soc, 2014, 22(S3): 4563-4566.
3. van Westrhenen A. De Cooman T, Lazeron RHC et al. Ictal autonomic changes as a tool for seizure detection:a systematic review. Clin Autsnomic Research, 2019, 29(2): 161-181.
4. Kosal E, Serdaroglu A, Cilsal E, et al. Can heart rate variability in children with epilepsy be used to predict seizures? Seizure, 2014, 23(5): 357-362.
5. Beniczky S, Jeppesen J. Nonelectroencephalography-based seizure detection. Curr Opin Neural, 2019, 32(2): 198-204.
6. Baumgartner C, Koreen JP. Seizure detection using sealp-EEG. Epilepsia, 2018, 59(S1): 14-22.
7. Fujwara K, Miyajima M, Yamaku wa T, et al. Epileptic seizure prediction based on multivariate statistical process control of heart rate variability feature. IEEE Trans Biomed Eng, 2016, 63(6): 1321-1332.
8. Stirling RE, Cook MJ, Grayden DB, et al. Seizure forecasting and cyclic control of seizure. Epilepsia, 2021, 62(Suppl 1): 2-14.
9. Qaraqe M, Ismail M, Serpedin E, et al. Epileptic seizure onset detection based on EEG and ECG data fusion. Epilepsy & Behavior, 2016, 58(1): 48-60.
10. Jeppesen J, Beniczky S, Fuglsang-Frederiken A, et al. Detection of epileptic-seizuers by means of pauser spectrum analysis of heart rate variability: a pilot study. Technology and Health Care, 2010, 18(6): 417-426.
11. Tomson T, Ericson M, Ihrman C, et al. Heart rate variability in patient with epilepsy. Epilepsy Research, 1998, 30(1): 77-83.
12. Varon C, Montalto A, Janson K, et al. Interictal cardiorespiratory variability in temporal lobe and absence epilepsy in childhood. Physiol Meas. 2015, 36(4): 845-856.
13. Liu HY, Yang Z, Meng FG, et al. Preoperative heart rate variability as predictors of vagus nerve stimulation outcome in patients with drug-resistant epilepsy. Sci Rep, 2018, 8(1): 38-56.
14. Persson H, Kumlien E, Ericson M, et al. Preoperative heart rate variability in relation to surgery outcome in refractory epilepsy. Neurology, 2005, 65(7): 1021-1025.
15. Eggleston KS, Olin BD, Fisher RS. Ictal tachycardia: the head-heart connection. seizure, 2014, 23(7): 496-505.
16. Hirsch M, Altermüller D-M, Schulze-Bonhage A. Lantenies from intracranal seizure onset to ictal tachycardia: a camparison to surface EEG patterns and other clinical signs. Epilepsia, 2015, 56(10): 1639-1647.
17. Sevcencu C, Struijk JJ. Autonomic alteration and cardiac changes in epilepsy. Epilepsia, 2010, 51(5): 725-737.
18. Jeppesen J, Fuglsang-Frederiken A, Johansen P, et al. Seizure detection based on heart rate variability using a wearable electrocardiography device. Epilepsia, 2019, 60(10): 2105-2113.
19. Schiecke C, Wacher M, Piper D, et al. Time-variant, frequency-selective, linear and nonlinear analysis of heart rate variability in children with temporal lobe epilepsy. IEEE Trans Biomed Eng, 2014, 61(6): 1798-1808.
20. Dalziel DJ, Uthman BM, McGorry SP, et al. Seizure-alert dogs, a review and preliminary study. Seizuer, 2003, 12(2): 115-120.
21. Osario I, Manly BEJ. Probability of detection of clinical seizures using heart rate changes. Seizure. 2015, 30(2): 120-123.
22. 王薇薇, 吴逊. 癫痫及癫痫发作中的心功能障碍. 中华神经科杂志, 2014, 47(3): 189-192.
23. Rugg-Gunn FJ, Simister RJ, Squirrell M, et al. Cardiac arrhythmias in focal epilepsy: a prospective long-term study. Lancet, 2004, 364(9452): 2212-2219.
24. Moseley BD, Nickels K, Briston J, et al. How common in ictal hypoxemia and bradyeardia in children with partial complex and generalized convulsion seizure ? Epilepsia, 2010, 51(7): 1219-1224.
25. 王薇薇, 吴逊. 癫痫自主神经发作及发作时的自主神经症状. 临床神经病学杂志, 2015, 28(4): 241-243.
26. Toth V, Hejiel L, Fogarasi A, et al. Periictal heart rate variability analysis suggests long-term postictal autonomic disturbance in epilepsy. European J Neunol, 2010, 17(6): 780-797.
27. Zijlmans M, Flanagan D, Gotman J. Heart rate changes and ECG abnormalities during epileptic seizure: prevalence and difinition of an objective clinical sign. Epilepsia, 2002, 43(8): 847-854.
28. Schernthaner C, Lindinger RJ, Squirrell M, et al. Autonomic epilepsythe influence of epileptic discharges on heart rate and rhythm. Wein Klin Wochenschn, 1999, 111(10): 392-401.
29. Myers KA, Bello-Espinosa LE, Symoneds JD, et al. Heart rate variability in epilepsy: a potential biomaker of sudden unexpected death in epilepsy risk. Epilepsia, 2018, 59(7): 1372-1380.
30. Goit RK, Jha SK, Pant BN. Alteration of cardiac autonomic function in patients with newly diagnosed epilepsy. Physiol Reperts, 2016, 4(11): e12826: 1-5.
31. Myers KA, Sivathamboo S, Perucca P. Heart rate variability measurement in epilepsy: How can we move from research to clinical practice? Epilepsia, 2018, 59(12): 2169-2178.
32. Mukherjee S, Tripathi M, Chandra PS, et al. Cardiovascular autonomic function in well-controlled and intratable partial epilepsies. Epilepsy Research, 2009, 85(2-3): 261-269.
33. Task Force of the European Sociaty of Cardiology and The North American Sociaty of Pacing and Electrophysiology. Heart rate variability standards of measurement, physiological interpretation, and clinical use. European Heart J, 1996, 17(3): 354-381.
34. Yildiz Gu, Dogan EA, Dogan U, et al. Analysis of 24 hours rate variations in patients with epilepsy receiving antiepileptic drugs. Epilepsy & Behavior 2011, 20(2): 349-345.
35. Behbahani S, Dabanloo NJ, Nasrabodi AM, et al. Preictal heart rate variability assessment of epileptic seizures by means of linear and non-linear analysis. Anadolu Kardiyol Derg, 2013, 13(8): 797-803.
36. Novak VV, Reeves LA, Novak P, et al. Time-frequency mapping of R-R interval during complex partial seizures of temporal lobe origin. J Auton Nerv Syst, 1999, 77(2-3): 195-202.
37. Baysal-Kirac L, Serbeet NG, Sahin E, et al. Analysis of heart rate variability and risk factors for SUDEP in patients with drug-resistant epilepsy. Epilepsy & Behavior, 2017, 71(1): 60-64.
38. Persson H, Ericson M, Tomson T. Heart rate variability in patient with untreat epilepsy. Seizure, 2007, 16(6): 504-508.
39. Brotherstone R, Mclellon A. Parasympathetic alteration during subclinical seizures. Seizure, 2012, 21(5): 391-398.
40. Leumezen F, Schernthaner C, Lurgen S, et al. Electrocardiographic changes at the onset of epileptic seizures. Epilepeia, 2003, 44(3): 348-354.
41. Sathyaprabha TN, Satishchandra P, Netravathi K, et al. Cardiac autonomic dysfunction in chronic refractory epilepsy. Epilepsy Research, 2006, 72(1): 49-56.
42. Suorsa E, Korpelainen JT, Ansakorpi H, et al. Heart rate dynamics in temporal lobe epilepsy-a long-term follow-up study. Epilepsy Research, 2011, 93(1): 80-83.
43. Harnod T, Yang CCH, Hsin Y-L, et al. Heart rate variability in patients with frontal lobe epilepsy. Seizure, 2009, 18(1): 21-25.
44. Malarvilli MB, Mesbah M. Newborn seizure detection based on heart rate variability. IEEE Trans Biomed Eng, 2009, 56(11): 2594-2603.
45. Jeppesen J, Beniczky C, Johansen P, et al. Comparing maximum autonomic activity of psychogenic non-epileptic seizures and epileptic seizures using heart rate variability. Seizure, 2016, 37(1): 13-19.
46. Ponnusamy A, Margues JLB, Reuber M. Comparison of heart variability parameters during complex partial seizures and psychagenic non-epileptic seizures. Epilepsia, 2012, 53(8): 1314-1321.
47. Harden C, Tomson T, Gloso D, et al. Practice guideline summary: Sudden unexpected death in epilepsy incidence rates and risk factors: Report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology and American Epilepsy Society. Epilepsy Currents, 2017, 17(3): 180-187.
48. Eppinger N, Shauman R, Jokert H, et al. Ruduced heart rate variability(HRV) in victims of sudden death in epilepsy(SUDEP). Epilepsia, 2004, 45(suppl 3): 65.

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