Ictal heart rate differentiates epileptic from nonepileptic seizures

Opherk C, Hirsch LJ. Neurology 2002; 58: 636-8.

Quick and dirty: Documenting an increase in HR during a spell of unresponsiveness usually can differentiate epileptic and psychogenic seizures. Study included 67 epileptic seizure patients and 38 psychogenic seizure patients. Analysis was of quiet staring spells. The positive predictive value was 97 % by using a cutoff of 30 % over baseline.

AAN 2010:  PO5:212  Periictal heart rate changes in patients with localization related epilepsy.  Jeong et al.  33 patients. HR changes were observed in 70 % of seizures, usually tachycardia.  (66% TACHYCARDIA, 4 % BRADYCARDIA) more often in right sided epilepsy than left (77v. 50 %) more in nonlesional than lesional epilepsy (82 v. 45 %)  and much earlier in mesial TLE than extratemporal epilepsy ( -54 v. -6 seconds) which may be useful to predict an epileptic event.