Heart Rate Controversies in Epilepsy: Autonomic Metrics and Predictions

Should we have a closer look at the beat-to-beat heart rate variations in people with epilepsy? The report by Sivathamboo et al.1 in this issue of Neurology® encourages us to do so. The investigators examined heart rate variability (HRV) among people who later died seemingly due to sudden unexpected death in epilepsy (SUDEP) and found lower HRV than in living epilepsy controls. These findings thus raise the question of whether autonomic metrics could help us improve SUDEP risk stratification.

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