Limits...
Cardiac arrest associated with epileptic seizures: A case report with simultaneous EEG and ECG.

Mehvari J, Fadaie F, Omidi S, Poorsina M, Najafi Ziarani M, Gharekhani M, Beladimoghadam N, Rahimian E, Moein H, Barakatain M, Basiratnia M, Hashemi Fesharaki SS - Epilepsy Behav Case Rep (2014)

Bottom Line: During long-term video-EEG monitoring, he had one generalized tonic-clonic seizure accompanied by bradycardia and cardiac asystole.In cases of epileptic cardiac dysrhythmia, prolonged simultaneous EEG/ECG monitoring may be required.Cardiological investigation should be included in epilepsy management.

View Article: PubMed Central - PubMed

Affiliation: Shefa Neuroscience Research Center, Khatamolanbia Hospital, Tehran, Iran ; Isfahan Neurosciences Research Center, Isfahan, Iran.

ABSTRACT
Ictal asystole is a rare, probably underestimated manifestation of epileptic seizures whose pathophysiology is still debated. This report describes two patients who had cardiac asystole at the end of their seizure. The first patient was a 13-year-old boy with complex partial seizures.. His MRI showed symmetrical signal abnormality in the bilateral parietooccipital lobe accompanied by mild gliosis and volume loss. During a 3-day long-term video-EEG monitoring, he had cardiac arrest at the end of one of his seizures that was secondarily generalized. The second one was a 42-year-old veteran with penetrating head trauma in the left frontal lobe due to shell injury. During long-term video-EEG monitoring, he had one generalized tonic-clonic seizure accompanied by bradycardia and cardiac asystole. Asystoles could have a role in the incidence of sudden unexpected death in epilepsy (SUDEP), meaning that the presence of ictal bradycardia is a risk factor for SUDEP. In cases of epileptic cardiac dysrhythmia, prolonged simultaneous EEG/ECG monitoring may be required. Cardiological investigation should be included in epilepsy management.

No MeSH data available.


Related in: MedlinePlus

© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4307967&req=5

Mentions: A 42-year-old right-handed male with seizure disorder was admitted for presurgical assessment. His epilepsy was due to penetrating head trauma in the left frontal lobe from a shell injury. Since then, he had been experiencing episodes of intense fear followed by generalized tonic–clonic movements. The attacks mostly occurred in sleep. These episodes recurred every 3–4 months. Neurologic examination included mild paresis in the right upper extremity and in the distal part of the right lower extremity in the range of 1–2/5. He had the Babinski sign in his right side. The gait was hemiparetic. Brain CT scan showed left parasagittal encephalomalacia (Fig. 8). During video-EEG monitoring, one seizure was recorded that was compatible with his habitual attacks. The very first clinical manifestation was after the initial EEG changes and consisted of a generalized tonic–clonic seizure with the last clonic jerk of the left arm. Afterwards, the SA arrest took place and lasted about 1 min (see Fig. 5, Fig. 6, Fig. 7). The very first EEG change started with 5-Hz spike–slow waves over the left parasagittal area with the maximum amplitude on C3 and F3. The interictal abnormality consisted of delta waves seen at P3, C3, and F3. Considering his cardiac arrest during the seizure, a cardiac consultation was done, and a pacemaker was implanted. During 24 months of antiepileptic regimen, the frequency of seizures was reduced remarkably. No cardiac problem was detected upon follow-up.


Cardiac arrest associated with epileptic seizures: A case report with simultaneous EEG and ECG.

Mehvari J, Fadaie F, Omidi S, Poorsina M, Najafi Ziarani M, Gharekhani M, Beladimoghadam N, Rahimian E, Moein H, Barakatain M, Basiratnia M, Hashemi Fesharaki SS - Epilepsy Behav Case Rep (2014)

© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4307967&req=5

Mentions: A 42-year-old right-handed male with seizure disorder was admitted for presurgical assessment. His epilepsy was due to penetrating head trauma in the left frontal lobe from a shell injury. Since then, he had been experiencing episodes of intense fear followed by generalized tonic–clonic movements. The attacks mostly occurred in sleep. These episodes recurred every 3–4 months. Neurologic examination included mild paresis in the right upper extremity and in the distal part of the right lower extremity in the range of 1–2/5. He had the Babinski sign in his right side. The gait was hemiparetic. Brain CT scan showed left parasagittal encephalomalacia (Fig. 8). During video-EEG monitoring, one seizure was recorded that was compatible with his habitual attacks. The very first clinical manifestation was after the initial EEG changes and consisted of a generalized tonic–clonic seizure with the last clonic jerk of the left arm. Afterwards, the SA arrest took place and lasted about 1 min (see Fig. 5, Fig. 6, Fig. 7). The very first EEG change started with 5-Hz spike–slow waves over the left parasagittal area with the maximum amplitude on C3 and F3. The interictal abnormality consisted of delta waves seen at P3, C3, and F3. Considering his cardiac arrest during the seizure, a cardiac consultation was done, and a pacemaker was implanted. During 24 months of antiepileptic regimen, the frequency of seizures was reduced remarkably. No cardiac problem was detected upon follow-up.

Bottom Line: During long-term video-EEG monitoring, he had one generalized tonic-clonic seizure accompanied by bradycardia and cardiac asystole.In cases of epileptic cardiac dysrhythmia, prolonged simultaneous EEG/ECG monitoring may be required.Cardiological investigation should be included in epilepsy management.

View Article: PubMed Central - PubMed

Affiliation: Shefa Neuroscience Research Center, Khatamolanbia Hospital, Tehran, Iran ; Isfahan Neurosciences Research Center, Isfahan, Iran.

ABSTRACT
Ictal asystole is a rare, probably underestimated manifestation of epileptic seizures whose pathophysiology is still debated. This report describes two patients who had cardiac asystole at the end of their seizure. The first patient was a 13-year-old boy with complex partial seizures.. His MRI showed symmetrical signal abnormality in the bilateral parietooccipital lobe accompanied by mild gliosis and volume loss. During a 3-day long-term video-EEG monitoring, he had cardiac arrest at the end of one of his seizures that was secondarily generalized. The second one was a 42-year-old veteran with penetrating head trauma in the left frontal lobe due to shell injury. During long-term video-EEG monitoring, he had one generalized tonic-clonic seizure accompanied by bradycardia and cardiac asystole. Asystoles could have a role in the incidence of sudden unexpected death in epilepsy (SUDEP), meaning that the presence of ictal bradycardia is a risk factor for SUDEP. In cases of epileptic cardiac dysrhythmia, prolonged simultaneous EEG/ECG monitoring may be required. Cardiological investigation should be included in epilepsy management.

No MeSH data available.


Related in: MedlinePlus