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Ictal tachycardia in patients with hypothalamic hamartoma
  1. Victoria San Antonio-Arce,
  2. Andreas Schulze-Bonhage
  1. Epilepsy Center, University Hospital Freiburg, Freiburg, Germany
  1. Correspondence to Dr Victoria San Antonio-Arce, Epilepsy Center, University Hospital Freiburg, Breisacher Str. 64, Freiburg 79106, Germany; victoriasanantonio{at}

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Epileptic seizures may lead to changes in autonomic function. Among these, changes in heart rate (HR) constitute an easily measurable biomarker that may provide an extracerebral indicator of an ictal onset in some patients, whereby new stimulation therapies triggered by tachycardia detection are being developed. Understanding the prevalence and magnitude of HR changes associated with seizures, as well as their mode of presentation, especially, the timing of such changes relative to seizure onset is fundamental to the development of HR-based algorithms for seizure detection. Likewise, identification of groups of patients presenting more likely with ictal tachycardia is important since these patients can be good candidates for stimulation therapies triggered by tachycardia detection.

Ictal tachycardia has been assessed in several studies and has been found in average in 82% of patients and in 76% of seizures, both focal and generalised, occurring early from several seconds before to several seconds after the seizure onset, raising a possibility for intervention.1 ,2 Most studies refer to patients with temporal or frontal lobe epilepsy or to consecutive patients who underwent video-EEG monitoring (VEM), regardless the type of epilepsy.

Patients with hypothalamic hamartoma (HH) constitute a special group among patients suffering from epilepsy. Owing to high …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.