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Cardiac asystole associated with seizures of right hemispheric onset.

Chu J, Majmudar S, Chen DK - Epilepsy Behav Case Rep (2014)

Bottom Line: Ictal asystole is frequently underrecognized despite being a potentially lethal condition.These cases are unique since previous literature reports that seizures associated with bradyarrhythmias typically arise from left hemispheric foci.These cases further underscore the importance of clinical vigilance and the need of an enhanced diagnostic biomarker.

View Article: PubMed Central - PubMed

Affiliation: Baylor College of Medicine, Neurology, One Baylor Plaza, NB302, Houston, TX 77030, USA.

ABSTRACT
Ictal asystole is frequently underrecognized despite being a potentially lethal condition. We report two cases of ictal asystole with right hemispheric onset. These cases are unique since previous literature reports that seizures associated with bradyarrhythmias typically arise from left hemispheric foci. These cases further underscore the importance of clinical vigilance and the need of an enhanced diagnostic biomarker.

No MeSH data available.


Related in: MedlinePlus

MRI of the brain. A) Axial T2 FLAIR with an enhancing lesion that extends along the right lateral ventricle and into the right frontal and temporal lobes, insula, thalamus, hypothalamus, right cerebral peduncle, and pons. B) Sagittal T1 postcontrast with lesion that extends along the right temporal lobe and insula region.
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f0010: MRI of the brain. A) Axial T2 FLAIR with an enhancing lesion that extends along the right lateral ventricle and into the right frontal and temporal lobes, insula, thalamus, hypothalamus, right cerebral peduncle, and pons. B) Sagittal T1 postcontrast with lesion that extends along the right temporal lobe and insula region.

Mentions: A 60-year-old woman presented with two seizures characterized by staring and altered awareness followed by left arm and leg shaking for 30 s. Simultaneously, her EKG revealed an initial bradycardia followed by asystole lasting 15 s. She required cardiopulmonary resuscitation for both episodes. Brain MRI revealed an enhancing lesion in the right hemisphere involving the frontal and temporal lobes, insula, thalamus, hypothalamus, and pons (Fig. 2). Brain biopsy was consistent with primary CNS lymphoma. Although her seizures were not corroborated by simultaneous EEG monitoring, the ictal semiology and imaging findings strongly support a right hemispheric epileptogenic zone. The patient underwent placement of a transcutaneous pacemaker.


Cardiac asystole associated with seizures of right hemispheric onset.

Chu J, Majmudar S, Chen DK - Epilepsy Behav Case Rep (2014)

MRI of the brain. A) Axial T2 FLAIR with an enhancing lesion that extends along the right lateral ventricle and into the right frontal and temporal lobes, insula, thalamus, hypothalamus, right cerebral peduncle, and pons. B) Sagittal T1 postcontrast with lesion that extends along the right temporal lobe and insula region.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4307876&req=5

f0010: MRI of the brain. A) Axial T2 FLAIR with an enhancing lesion that extends along the right lateral ventricle and into the right frontal and temporal lobes, insula, thalamus, hypothalamus, right cerebral peduncle, and pons. B) Sagittal T1 postcontrast with lesion that extends along the right temporal lobe and insula region.
Mentions: A 60-year-old woman presented with two seizures characterized by staring and altered awareness followed by left arm and leg shaking for 30 s. Simultaneously, her EKG revealed an initial bradycardia followed by asystole lasting 15 s. She required cardiopulmonary resuscitation for both episodes. Brain MRI revealed an enhancing lesion in the right hemisphere involving the frontal and temporal lobes, insula, thalamus, hypothalamus, and pons (Fig. 2). Brain biopsy was consistent with primary CNS lymphoma. Although her seizures were not corroborated by simultaneous EEG monitoring, the ictal semiology and imaging findings strongly support a right hemispheric epileptogenic zone. The patient underwent placement of a transcutaneous pacemaker.

Bottom Line: Ictal asystole is frequently underrecognized despite being a potentially lethal condition.These cases are unique since previous literature reports that seizures associated with bradyarrhythmias typically arise from left hemispheric foci.These cases further underscore the importance of clinical vigilance and the need of an enhanced diagnostic biomarker.

View Article: PubMed Central - PubMed

Affiliation: Baylor College of Medicine, Neurology, One Baylor Plaza, NB302, Houston, TX 77030, USA.

ABSTRACT
Ictal asystole is frequently underrecognized despite being a potentially lethal condition. We report two cases of ictal asystole with right hemispheric onset. These cases are unique since previous literature reports that seizures associated with bradyarrhythmias typically arise from left hemispheric foci. These cases further underscore the importance of clinical vigilance and the need of an enhanced diagnostic biomarker.

No MeSH data available.


Related in: MedlinePlus