T-wave heterogeneity crescendo in the surface EKG is superior to heart rate acceleration for seizure prediction

•Accurate seizure prediction is a key goal of the epilepsy community.•T-wave heterogeneity provides 30-min warning time for GTCS onset compared to 10-min warning by increases in heart rate.•T-wave heterogeneity may also distinguish patients with GTCS from those with psychogenic nonepileptic events....

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Bibliographic Details
Published in:Epilepsy & behavior 2022-05, Vol.130, p.108670-108670, Article 108670
Main Authors: Pang, Trudy D., Nearing, Bruce D., Verrier, Richard L., Schachter, Steven C.
Format: Article
Language:English
Subjects:
Acceleration
Arrhythmias, Cardiac
Cardiac
Electrocardiography
Electroencephalography
Heart Rate
Humans
Psychogenic nonepileptic seizures
Seizure prediction
Seizures - diagnosis
T-wave heterogeneity
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Summary:•Accurate seizure prediction is a key goal of the epilepsy community.•T-wave heterogeneity provides 30-min warning time for GTCS onset compared to 10-min warning by increases in heart rate.•T-wave heterogeneity may also distinguish patients with GTCS from those with psychogenic nonepileptic events. We examined whether T-wave heterogeneity (TWH) on the surface electrocardiographic (EKG) could predict epileptic seizure onset. Patients with electroencephalography-confirmed generalized tonic-clonic seizures (GTCS) (n = 6) exhibited abnormal elevations in TWH (>80 µV) at baseline (105 ± 20.4 µV), which increased from 30 min prior to seizure without heart rate increases > 2 beats/min until 10 min pre-seizure. Specifically, TWH on 3-lead surface EKG patch recordings increased from 1-hour baseline to 30 min (
ISSN:1525-5050
1525-5069
DOI:10.1016/j.yebeh.2022.108670