癫痫与心脏自主神经功能障碍

Epilepsy and dysfunction of cardiac autonomic nervous system

目的:分析癫痫患者发作期和发作间期自主神经功能障碍与癫痫患者突然意外死亡的关系。资料来源:应用计算机检索Medline数据库1985-01/2004-12期间的相关文章限定文章语言种类为英文,检索词“epilepsyandautonomic”和“seizureandautonomic”。资料选择:对资料进行初审,纳入标准:①癫痫和癫痫发作与自主神经功能状态关系。②癫痫突然意外死亡。资料提炼:共收集到符合上述要求的文献45篇,排除27篇重复性内容。18篇符合纳入标准:其中16篇关于癫痫和癫痫发作与自主神经功能障碍,2篇关于自主神经功能障碍与癫痫患者突然意外死亡的关系。资料综合:癫痫和癫痫发作均可引起心脏自主神经功能障碍,无论部分性发作还是全身性发作癫痫患者发作期和发作间期都存在自主神经功能障碍。而心脏自主神经功能障碍与心律失常尤其是恶性心律失常的发生密切相关。结论:癫痫患者发作期和发作间期心脏自主神经功能障碍引发的恶性心率失常可能是癫痫患者发生突然意外死亡的重要原因。

OBJECTIVE： To analyze the relationship between dysfunction.of cardiac autonomic nervous system and accidental death in patients with epilepsy during period and interval of onset. DATA SOURCES： Relevant articles from January 1985 to December 2004 were searched with computer in Medline with the key words of ＂epilepsy and autonomic; seizure and autonomic＂ and language was limited to English. STUDY SELECTION： Data were retrieved in the primary selection. Inclusive eriteria：①Relationship between epilepsy, seizure and autonomic nervous funetion.②Sudden death induced by epilepsy. DATA EXTRACTION： A total of 45 literatures in accordance with the criteria were collected, 27 repetitive studies were excluded. Eighteen articles were in accordance with the inclusive criteria： 16 of which related to epilepsy, seizure and dysfunction of cardiac autonomic nervous system, 2 were in relation to the correlation between cardiac autonomic nervous dysfunction and accidental death of patients with epilepsy. DATA SYNTHESIS： Both epilepsy and seizure can induce cardiac autonomic nervous dysfunction, which existed in patients with no matter partial seizures or generalized seizures during period and interval of onset. Dysfunction of cardiac autonomic nervous system was closely correlated with cardiac arrhythmia （CA） especially with malignant CA. CONCLUSION： Malignant CA induced by dysfunction of cardiac autonomic nervous system in patients with epilepsy during period and seizure of onset is an important cause of sudden accidental death.