Effectiveness of rehabilitation of patients with epilepsy: assessment of autonomic nervous system functioning

Authors:

Mikhail A. Kachkovsky, Grand PhD in Medical sciences, Professor. Director of Scientific Research Institute of Atherosclerosis and Dyslipidemias, Professor of the Department of Internal Medicine of the Medical University “Reaviz”, 227 Chapayevskaya Street, 443001 Samara, Russian Federation. E-mail: KachkovskyMA@reaviz.ru

Konstantin N. Melnikov, PhD in Medical sciences. Lecturer at the  Department of Clinical Medicine of the Medical University “Reaviz”, neurologist of Multidisciplinary Clinic “Reaviz”, 227 Chapayevskaya Street, 443001 Samara, Russian Federation. E-mail: konstanmelni@yandex.ru

Annotation:

Introduction. Patients with epilepsy are one of the most vulnerable populations. Rehabilitation of this category of patients is difficult problem due to stigmatization and the negative impact of seizures on social activity.

Aim. The aim is to evaluate the effectiveness of rehabilitation of patients with epilepsy through the study of the autonomic nervous system.
Materials and methods. Changes in the autonomic nervous system were analyzed in patients with focal seizures with a transition to a bilateral tonic-clonic seizure of various frequencies. The study was conducted by studying heart rate variability and using the A.M. Wayne questionnaire.

Results. The autonomic nervous system dysfunction was revealed in all patients with epilepsy. The study of heart rate variability demonstrates a significant decrease in the total spectral power, showing the level of adaptive reserves, which is more pronounced in patients with frequent seizures. A significant predominance of sympathetic regulation is noted due to a decrease in the degree of influence of parasympathetic regulation.

Discussion. The data were obtained earlier on the autonomic disbalance in patients with epilepsy, which con- tributes to the occurrence of arrhythmias in them. Other authors in patients with epilepsy, especially with panic attacks, revealed a greater severity of changes in the autonomic nervous system. Our study found that the degree of autonomic dysfunction increased significantly in patients with structural epilepsy with high frequency tonic-clonic seizures, which can be used as an additional objective sign of the severity of maladaptation.

Conclusion. Epilepsy is the cause of autonomic dysfunction. Focal seizures with a transition to bilateral tonic- clonic seizures have a negative effect on the suprasegmental level of autonomic regulation. The state of the au- tonomic nervous system reflects the capabilities of the adaptive function of a person, the degree of his physical and social activity. The study of heart rate variability allows a comprehensive digital assessment of the autonomic nervous system and the degree of rehabilitation.

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