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Hyperventilation and Seizures: Not a New sense: A Literature review

Journal

NEUROPEDIATRICS
Volume 54, Issue 6, Pages 359-364

Publisher

GEORG THIEME VERLAG KG
DOI: 10.1055/s-0043-1774808

Keywords

epilepsy; absence; generalized; focal; hyperventilation; hypocapnia

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Hyperventilation has a long history of association with seizures and is commonly used in clinical practice to assist with the diagnosis of epilepsy. It can activate epileptiform spiking activity more often than seizures, but its triggering effects vary depending on patient and epilepsy types.
Hyperventilation and seizures have a long association in the clinical literature and were known to have a relationship long before the electroencephalogram (EEG) was used to record changes in brain activity. As the use of EEG recording progressed, hyperventilation was the first activation method used to assist with diagnosis of epilepsy. Along with slowing of brain activity, hyperventilation can activate epileptiform spiking activity in patients with epilepsy. Currently, hyperventilation is used in standard practice to assist with the diagnosis of epilepsy during EEG recording. Hyperventilation activates epileptiform spiking activity more often than seizures but can trigger clinical seizures in up to 50% of patients with generalized epilepsy. It is more likely to trigger events in children with absence seizures than adults, and it acts as a trigger in patients with focal epilepsy far less often. However, while some clinicians suggest that its diagnostic value is limited, especially in adults with focal epilepsies, others suggest that it is simple, safe, and an important diagnostic tool, even in these patients. This review presents the history of hyperventilation and seizures, its use in the clinical practice, and possible mechanisms involved.

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