Brain Rattled, Heart Shackled: Ictal Asystole in a Patient without Prior History of Epilepsy or Arrhythmia
Open Access
- 1 January 2022
- journal article
- research article
- Published by Scientific Research Publishing, Inc. in World Journal of Cardiovascular Diseases
- Vol. 12 (04), 228-235
- https://doi.org/10.4236/wjcd.2022.124023
Abstract
We present a case of ictal asystole in an 81-year-old female, with no prior history of epileptic activity, or cardiac history suggestive of arrhythmia, who suffered several seemingly unrelated epileptic and asystolic episodes prior to finally having a witnessed seizure followed by an asystolic event. Following this event, all atrioventricular (AV) nodal blockers, and medications with potential seizure threshold lowering activity were stopped, and anti-epileptic medication was optimized. Due to the wishes of the patient’s family, no invasive interventions were pursued.However, the patient continued to be medically treated with anti-epileptic therapy and had no further asystolic events. Unfortunately, the patient’s overall clinical status deteriorated, and she subsequently passed during her hospital stay after being made do not resuscitate and do not intubate (DNR/DNI) by the family and then subsequently comfort care. Prior to her passing, however, she had remained free of epileptic events for 10 days and free of asystolic events for 21 days.Keywords
This publication has 11 references indexed in Scilit:
- Ictal Asystole in Drug-Resistant Focal Epilepsy: Two Decades of Experience from an Epilepsy Monitoring UnitBrain Sciences, 2020
- Ictal asystole with isolated syncope: A case report and literature reviewEpilepsy & Behavior Case Reports, 2018
- Ictal asystole: a case presentationBMC Neurology, 2018
- Recurrence risk of ictal asystole in epilepsyNeurology, 2017
- Cardiac arrhythmias during or after epileptic seizuresAutonomic Neuroscience, 2015
- Ictal AsystoleCirculation: Arrhythmia and Electrophysiology, 2015
- Ictal Asystole and Ictal SyncopeCirculation: Arrhythmia and Electrophysiology, 2015
- Seizure Incidence in Psychopharmacological Clinical Trials: An Analysis of Food and Drug Administration (FDA) Summary Basis of Approval ReportsBiological Psychiatry, 2007
- 10/20, 10/10, and 10/5 systems revisited: Their validity as relative head-surface-based positioning systemsNeuroImage, 2007
- Brain seizes, heart ceases: a case of ictal asystoleJournal of Neurology, Neurosurgery & Psychiatry, 2000