scholarly journals Simulated driving in the epilepsy monitoring unit: Effects of seizure type, consciousness, and motor impairment

Epilepsia ◽  
2021 ◽  
Author(s):  
Avisha Kumar ◽  
Reese Martin ◽  
William Chen ◽  
Andrew Bauerschmidt ◽  
Mark W. Youngblood ◽  
...  
Keyword(s):  
Motor Impairment ◽  
Seizure Type ◽  
Simulated Driving ◽  
Epilepsy Monitoring

P5346The effect of seizure type on ictal and early post-ictal Heart Rate Variability in patients with focal resistant epilepsy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M T Faria ◽  
S Rodrigues ◽  
D Dias ◽  
R Rego ◽  
H Rocha ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Refractory Epilepsy ◽  
Ethics Committee ◽  
Wilcoxon Test ◽  
Seizure Type ◽  
Seizure Onset ◽  
Unexpected Death ◽  
Clonic Seizures ◽  
Epilepsy Monitoring

Abstract Background Seizures commonly affect the heart rate and its variability. The increased interest in this area of research is related to the possible connection with sudden unexpected death in epilepsy (SUDEP). Generalized tonic-clonic seizures (GTCS) are reported as the most consistent risk factor for SUDEP. However, the general risk of seizures (and their type) on cardiac function still remains uncertain. Purpose To evaluate the influence of seizure type (GTCS vs non-GTCS) on ictal and early post-ictal Heart Rate Variability (HRV) in patients with refractory epilepsy. Methods From January 2015 to July 2018, we prospectively evaluated 121 patients admitted to our institution's Epilepsy Monitoring Unit with focal resistant epilepsy. All patients underwent a 48-hour Holter recording. We included only patients who had both GTCS and non-GTCS during the recording and selected the first seizure of each type to analyze. HRV (AVNN, SDNN, RMSSD, pNN50, and LF/HF) was evaluated by analyzing 5-min-ECG epochs, starting with the seizure onset (ictal and early post-ictal period). The study was approved by our Institution Ethics Committee and all patients gave informed consent. Results Fourteen patients were included (7 Females, 4 patients with Temporal Lobe Epilepsy). The median age was 39 years (min-max, 18–57). Thirty-six percent presented cardiovascular risk factors without known cardiac disease. A significant statistical reduction was found for AVNN (p=0.013), RMSSD (p=0.008), pNN50 (p=0.005) and HF (p=0.003), during GTCS when compared with non-GTCS (Wilcoxon test, p<0.05; two tailed). Conclusion Our study shows a significant reduced vagal tone during GTCS when compared with non-GTCS. Hence, GTCS had a more pronounced impact on HRV changes than other seizure types, which can be associated with higher SUDEP risk after GTCS.

Linking motor impairment to function

2000 ◽  
Vol 42 (01) ◽  
pp. 69 ◽  
Author(s):  
Bernard Dan ◽  
Guy Cheron
Keyword(s):  
Motor Impairment

Effects of ADHD in College Students on Attention and Performance During Simulated Driving

2006 ◽  
Author(s):  
Melissa Falzetta ◽  
Lee Gugerty
Keyword(s):  
College Students ◽  
Simulated Driving ◽  
And Performance

Stereoscopic displays for robot teleoperation and simulated driving

2010 ◽  
Author(s):  
Jessie Y. C. Chen ◽  
Razia N. V. Oden ◽  
Caitlin Kenny ◽  
John O. Merritt
Keyword(s):  
Simulated Driving ◽  
Stereoscopic Displays

scholarly journals Adaptive mechanisms driving maladaptive pain: how chronic ongoing activity in primary nociceptors can enhance evolutionary fitness after severe injury

2019 ◽  
Vol 374 (1785) ◽  
pp. 20190277 ◽  
Author(s):  
Edgar T. Walters
Keyword(s):  
Chronic Pain ◽  
Motor Impairment ◽  
Low Frequency ◽  
Severe Injury ◽  
Ongoing Activity ◽  
Pain Mechanisms ◽  
Bodily Injury ◽  
Adaptive Mechanisms ◽  
Survival And Reproduction ◽  
Ongoing Pain

Chronic pain is considered maladaptive by clinicians because it provides no apparent protective or recuperative benefits. Similarly, evolutionary speculations have assumed that chronic pain represents maladaptive or evolutionarily neutral dysregulation of acute pain mechanisms. By contrast, the present hypothesis proposes that chronic pain can be driven by mechanisms that evolved to reduce increased vulnerability to attack from predators and aggressive conspecifics, which often target prey showing physical impairment after severe injury. Ongoing pain and anxiety persisting long after severe injury continue to enhance vigilance and behavioural caution, decreasing the heightened vulnerability to attack that results from motor impairment and disfigurement, thereby increasing survival and reproduction (fitness). This hypothesis is supported by evidence of animals surviving and reproducing after traumatic amputations, and by complex specializations that enable primary nociceptors to detect local and systemic signs of injury and inflammation, and to maintain low-frequency discharge that can promote ongoing pain indefinitely. Ongoing activity in nociceptors involves intricate electrophysiological and anatomical specializations, including inducible alterations in the expression of ion channels and receptors that produce persistent hyperexcitability and hypersensitivity to chemical signals of injury. Clinically maladaptive chronic pain may sometimes result from the recruitment of this powerful evolutionary adaptation to severe bodily injury. This article is part of the Theo Murphy meeting issue ‘Evolution of mechanisms and behaviour important for pain’.

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