Epilepsy
Conditions
Keywords
Dravet syndrome, Sudden Unexpected Death in Epilepsy (SUDEP), Arrhythmias
Brief summary
SUMMARY Rationale: People with Dravet Syndrome (DS), a rare epilepsy syndrome, have a high risk of Sudden Unexpected Death in Epilepsy (SUDEP). Mouse models indicated that the responsible sodium channel mutation (SCN1A) not only alters cortical excitability but also increases the propensity to arrhythmias. Little is known yet about the prevalence of seizure-induced arrhythmias in human DS subjects. Objective: To assess the prevalence of cardiac arrhythmias in DS and to compare the prevalence of cardiac arrhythmias between DS subjects and subjects with other types of epilepsy. Study design: Observational study. Study population: Subjects with Dravet syndrome and a known pathogenic SCN1A mutation, seizure frequency ≥ 1/week (all seizure types except for absences or myoclonias), age ≥ 6 years and no signs of self-harm. Each case will be matched to two historical controls (age +/- 5 years) from the EEG databases of the participating centres. Only those controls with two or more recorded seizures will be matched to the cases. Intervention: Not applicable Main study parameters/endpoints: Ictal asystole Ictal bradycardia Ictal QT-shortening/lengthening Nature and extent of the burden and risks associated with participation, benefit and group relatedness: Participation does not carry risks. The sensor is wearable and miniaturised, thus minimising discomfort. If this nevertheless may occur, the study can be terminated. This study provides specific tools to investigate the seizure-related heart rate response. Subjects may thus benefit from participation by identification of otherwise unknown arrhythmias. The rationale of the study (the high SUDEP risk and the evidence in animal studies for arrhythmic cause of sudden death) specifically applies to DS, a rare epileptic syndrome including minors and incapacitated persons. The investigators believe that the lack of risks, the potential diagnostic benefit, the minimal intervention with novel and wearable sensors and the possibility to terminate the study in case of discomfort, justifies the study in this patient group.
Interventions
None listed
Sponsors
Epilepsiefonds
Stichting Epilepsie Instellingen Nederland
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
6 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Criteria: Cases must meet all of the following criteria: 1. DS with a known pathogenic SCN1A mutation 2. seizure frequency ≥ 1/week (all seizure types expect for absences or myoclonias) 3. no self-harm 4. age ≥ 6 years Each case will be matched to two historical controls (age +/- 5 years). Controls will meet the following criteria: 1. definite diagnosis of epilepsy 2. no clinical suspicion of DS 3. at least two seizures recorded (all seizure types expect for absences or myoclonias) during video-EEG registration. 4. age ≥ 6 years
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Ictal asystole (sinus arrest ≥ 3 s) or ictal bradycardia (< 2nd heart rate percentile for age) | We will record heart rate patterns during seizures with miniaturized wearable EKG-monitors for 2 periods of 10 days |
Secondary
| Measure | Time frame |
|---|---|
| Ictal QT lengthening or shortening | We will record heart rate patterns during seizures with miniaturized wearable EKG-monitors for 2 periods of 10 days |
Countries
Germany, Netherlands, United Kingdom
Outcome results
None listed