الفهرس 
ContentsOnly 14 pages are availabe for public view
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Abstract
Epilepsy is one of the most common neurological disorders in children. The overall estimated incidence is about 3% with more than half of them begin at childhood. Epilepsy is defined as recurrent unprovoked seizures, caused by discharging foci in the cerebrum. Epilepsy has been proven to cause permanent neuro-degeneration and progressive brain damage. The expected effect of an epileptic seizure is a sympathetic discharge that would increase the heart rate, blood pressure, cardiac output, and respiratory rate to meet the increased metabolic demands of the convulsing brain. Concomitant increases in heart rate, blood pressure, and myocardial contractility, along with augmented cardiac afterload from tonic muscle contraction, all lead to increase in the myocardial oxygen demand. Simultaneously, ictal apnea may lead to hypoxia. The resultant mismatch between myocardial metabolic demands and oxygen delivery could produce myocardial ischemia. This study design is a case control study.The study was conducted at the in-patient ward and the out-patient clinic of pediatric neurology & general pediatric clinic in Mansoura University Children Hospital ―MUCH‖ which serves Dakahlia Governorate and surrounding areas. Elevated serum CTnI level was observed in 15 epileptic children (27.5%) who underwent a detailed ECHO study which was done by an expert cardiologist and then after 4 weeks, they were re-evaluated by serum CTnI and a follow-up ECHO study. Systolic dysfunction detected by decreased S wave velocity & increased IVCT in patients compared to control. Moreover, MPI increased in patients compared to control which is considered a parameter of both systolic and diastolic dysfunction. In speckle tracking, both GLS & GCS are decreased in patients compared to control. Subclinical myocardial dysfunction is evident in epileptic children. Serum CTnI is a good marker for detection of subtle myocardial dysfunction in epileptic children. Different echocardiographic modalities can be used in diagnosis of myocardial dysfunction, However STE is an accurate and sensitive method in detection of subtle myocardial dysfunction. Both systolic and diastolic functions are affected in epileptic patients with elevated serum CTnI and the dysfunction continue even with the returning of serum CTnI to normal level. Serum CTnI level is negatively correlated with S wave, GLS and GCS. Patients received multiple anti-epileptic drugs (resistant epilepsy) have increased risk for cardiac affection.