Ictal Asystole in Drug-Resistant Focal Epilepsy: Two Decades of Experience from an Epilepsy Monitoring Unit
Open Access
- 12 July 2020
- journal article
- research article
- Published by MDPI AG in Brain Sciences
- Vol. 10 (7), 443
- https://doi.org/10.3390/brainsci10070443
Abstract
Background: Ictal asystole (IA) is a rare event observed in people with epilepsy (PwE). Clinical and IA video-electroencephalographic findings may be helpful in screening for high-risk subjects. Methods: From all PwE undergoing video-EEG for presurgical evaluation between 2000 and 2019, we retrospectively selected those with at least one IA (R–R interval of ≥3 s during a seizure). Results: IA was detected in eight out of 1088 (0.73%) subjects (mean age: 30 years; mean epilepsy duration: 9.6 years). Four out of them had a history of atonic falls. No patients had cardiac risk factors or cardiovascular diseases. Seizure onset was temporal (n = 5), temporo-parietal (n = 1) or frontal (n = 2), left-sided and right-sided in five and two patients, respectively. In one case a bilateral temporal independent seizure onset was recorded. IA was recorded in 11 out of 18 seizures. Mean IA duration was 13 s while mean IA latency from seizure onset was 26.7 s. Symptoms related to IA were observed in all seizures. Conclusion: IA is a rare and self-limiting event often observed during video-EG in patients with a history of atonic loss of consciousness and/or tardive falls in the course of a typical seizure.This publication has 26 references indexed in Scilit:
- Management and long-term outcome in patients presenting with ictal asystole or bradycardiaEpilepsia, 2011
- The treatment of ictal asystole with cardiac pacingEpilepsia, 2011
- Autonomic alterations and cardiac changes in epilepsyEpilepsia, 2010
- Ictal asystole—Late manifestation of partial epilepsy and importance of cardiac pacemakerSeizure, 2009
- Video-electrographic and clinical features in patients with ictal asystoleNeurology, 2007
- The Ictal Bradycardia Syndrome: Localization and LateralizationEpilepsia, 2006
- Seizures and syncope:Clinical Autonomic Research, 2006
- Ictal asystole with convulsive syncope mimicking secondary generalisation: a depth electrode studyJournal of Neurology, Neurosurgery & Psychiatry, 2005
- Cardiac Asystole in Epilepsy: Clinical and Neurophysiologic FeaturesEpilepsia, 2003
- Surgery for SeizuresThe New England Journal of Medicine, 1996