Spontaneous oscillations in cerebral blood flow velocities in middle cerebral arteries in control subjects and patients with epilepsy.

Background and Purpose: Cardiac arrhythmias mediated by the sympathetic nervous system have been implicated in sudden, unexplained deaths in patients with epilepsy. Cerebral blood flow velocities (CBFV) as measured by transcranial Doppler are characterized by slow spontaneous oscillations in part at...

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Published in:Stroke (00392499) Vol. 28; no. 12; pp. 2457 - 2460
Main Authors: Diehl, B, Diehl, R R, Stodieck, S R, Ringelstein, E B
Format: research Journal Article
Published: Lippincott Williams & Wilkins 1997 Dec
Online Access:View this record in EBSCOhost
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      dt: 1997 Dec
      vid: 28
      iid: 12
      pid: 433
      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        119715283
        119715283
        NLM9412632
        119715283
        10.1161/01.str.28.12.2457
        NLM9412632
        119715283
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        atl: Spontaneous oscillations in cerebral blood flow velocities in middle cerebral arteries in control subjects and patients with epilepsy.
      aug:
        au:
          Diehl, B
          Diehl, R R
          Stodieck, S R
          Ringelstein, E B
        affil: Department of Neurology, University Hospital, Münster, Germany
      sug:
        subj:
          Cerebral Arteries Physiopathology
          Epilepsy, Generalized Physiopathology
          Blood Flow Velocity Physiology
          Cerebrovascular Circulation Physiology
          Male
          Electroencephalography
          Human
          Adult
          Female
          Physics
          Ultrasonography, Doppler, Transcranial
          Mathematics
          Reference Values
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Clinical Assessment Tools
          Adult: 19-44 years
          Male
          Female
      ab: Background and Purpose: Cardiac arrhythmias mediated by the sympathetic nervous system have been implicated in sudden, unexplained deaths in patients with epilepsy. Cerebral blood flow velocities (CBFV) as measured by transcranial Doppler are characterized by slow spontaneous oscillations in part attributed to changes in sympathetic activity (M waves, 3 to 9 cycles per minute) and to discharges of monoaminergic neurons in the brain stem (B waves, 0.5 to 2 cycles per minute). This study was designed to compare spontaneous fluctuations of CBFV in patients with epilepsy with those in normal control subjects.Methods: Simultaneous registrations of scalp electroencephalograms, with electrodes placed according to the 10-20 System, and transcranial Doppler recordings of both middle cerebral arteries were performed in 27 patients (9 with primary generalized epilepsy, 18 with focal epilepsy). Data analysis of CBFV was based on the envelope curves of the Doppler spectrum. A fast Fourier transformation over the 20-minute CBFV curve was performed, and the amplitudes of B and M waves were calculated and compared with those in 20 normal, age-matched control subjects.Results: While the amplitudes of the B waves in both groups were similar, patients with epilepsy showed significantly increased M waves. Patients with focal epilepsy did not present asymmetries between the normal hemisphere and the side of the epileptic focus with respect to both M and B waves.Conclusions: Enhanced M waves in epileptic patients may reflect increased sympathetic activity even in the absence of seizures. This study provides further evidence for an autonomic dysfunction as a possible mechanism for sudden unexplained death in patients with epilepsy.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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