Affiliations: Department of Pediatrics, Faculty of Medicine, Ain
Shams University, Cairo, Egypt | Department of Clinical Pathology, Faculty of Medicine,
Ain Shams University, Cairo, Egypt
Note: [] Correspondence: Dr. Rasha H. Aly, 2 El Sobky Street, Heliopolis,
Cairo, Egypt. Tel.: +20 1223220859; E-mail: [email protected]
Abstract: To evaluate ictal serum levels of heart type fatty acid binding
protein (H-FABP) in children with intractable epilepsy as a marker of cardiac
ischemia in comparison to their levels in the interictal period and that of
controls. The study included 23 seizure episodes recorded in 14 patients with
intractable seizures. Serum levels of H-FABP in the ictal and interictal
periods were done as well as simultaneous electrocardiogram, Holter and video
electroencephalography recordings with evaluation of changes in the heart rate
(HR), and HR variability parameters. Levels of H-FABP were higher in the
patients' group whether in the ictal or interictal periods compared to the
control group. However, levels were not significantly different in the ictal
period compared to the interictal one. Ictal tachycardia was recorded in 95%
and bradycardia in 5% of the studied seizures episodes. Premature atrial and
ventricular contractions were recorded in the 1st postictal hour of 8.7% and
30.4% of the recorded seizures, respectively. Interictal values showed
significant increase minutes before the onset of the seizures and remained high
2 hours postictally. All time domain HR variability parameters were lower in
the patients' group. Our results showed significant increase in the serum
levels of H-FABP in our patients' group, which might suggest a degree of
myocardial ischemia even in asymptomatic patients. Though bradycardia,
prolonged QTc and arrhythmic changes were reported in few cases, the importance
of the results warrants studying those changes at least in patients with refractory seizures.
