Markers of peri-ictal cardiac injury in epileptic seizures
Research type
Research Study
Full title
Markers of peri-ictal cardiac injury in epileptic seizures
IRAS ID
163778
Contact name
Dora A Lozsadi
Contact email
Sponsor organisation
St Georges NHS Trust
Duration of Study in the UK
0 years, 9 months, 30 days
Research summary
Risk of death for patients suffering from epilepsy is 20x higher than that of the general population. For example sudden unexpected death in epilepsy (SUDEP) and circulatory complications contribute to reduced life expectancy. Tonic-clonic seizures are known to be associated with reversible adrenalin induced heart muscle damage. Other, milder attacks may cause irregular heartbeat. Preliminary data collected by our team (Hemsworth et al. 2014) suggests a broader association. 42% of individuals presenting to St George’s as an emergency with isolated seizures had positive markers of heart muscle injury often without pre-existing cardiovascular risk factors. We aim to identify patient groups at risk of cardiac injury at time of a seizure, informing future screening and prevention.
We will assess fifty consented patients admitted to SGH for routine in-patient brain wave (EEG) monitoring. Patients older than 16 years with confirmed diagnosis of epilepsy and capacity to give consent will be included. We will collect demographic data, as well as information on individual’s epilepsy and risk factors for heart disease. Blood tests (troponin T and serum Brain Natriuretic Peptide) and a 12 lead electrocardiogram (ECG) will be requested at time of recruitment (baseline) and following each seizure. Abnormal results will be followed up as part of routine care. Collected data will be analysed in conjunction with video EEG recording seizure type, captured heart-rate, -rhythm changes during seizures.
Our study plans to identify seizure types associated with heart muscle or heart-rate changes. We expect to describe clinical markers / predisposition to high risk seizures. Our results are likely to add invaluable information to refine a suggested screening tool: the ‘SUDEP safety checklist’ (Shankar et al. 2013). If validated, this may become a widely used method identifying patients at risk of premature death. Brain natriuretic peptide may prove a marker of generalized tonic clonic seizures in adults.REC name
London - Fulham Research Ethics Committee
REC reference
15/LO/1208
Date of REC Opinion
27 Jul 2015
REC opinion
Further Information Favourable Opinion