Titre du document / Document title

Video-electrographic and clinical features in patients with ictal asystole

Auteur(s) / Author(s)

SCHUELE S. U. ^{(1 2)} ; BERMEO A. C. ⁽¹⁾ ; ALEXOPOULOS A. V. ⁽¹⁾ ; LOCATELLI E. R. ⁽¹⁾ ; BURGESS R. C. ⁽¹⁾ ; DINNER D. S. ⁽¹⁾ ; FOLDVARY-SCHAEFER N. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Cleveland Clinic, OH, ETATS-UNIS
⁽²⁾ Northwestern University, Chicago, IL, ETATS-UNIS

Résumé / Abstract

Objective: Ictal asystole (IA) is a rare event mostly seen in patients with temporal lobe epilepsy (TLE) and a potential contributor to sudden unexplained death in epilepsy (SUDEP). Clinical and video-electroencephalographic findings associated with IA have not been described, and may be helpful in screening for high risk patients. Methods: A database search was performed of 6,825 patients undergoing long-term video-EEG monitoring for episodes of IA. Results: IA was recorded in 0.27% of all patients with epilepsy, eight with temporal (TLE), two with extratemporal (XTLE), and none with generalized epilepsy. In 8 out of 16 recorded events, all occurring in patients with TLE, seizures were associated with a sudden atonia on average 42 seconds into the typical semiology of a complex partial seizure. The loss of tone followed after a period of asystole usually lasting longer than 8 seconds and was associated with typical EEG changes seen otherwise with cerebral hypoperfusion. Clinical predisposing factors for IA including cardiovascular risk factors or baseline ECG abnormalities were not identified. Conclusion: Ictal asystole is a rare feature of patients with focal epilepsy. Delayed loss of tone is distinctly uncommon in patients with temporal lobe seizures, but may inevitably occur in patients with ictal asystole after a critical duration of cardiac arrest and cerebral hypoperfusion. Further cardiac monitoring in patients with temporal lobe epilepsy and a history of unexpected collapse and falls late in the course of a typical seizure may be warranted and can potentially help to prevent sudden unexplained death in epilepsy.

Revue / Journal Title

Neurology    ISSN  0028-3878   CODEN NEURAI 

Source / Source

2007, vol. 69, n^o5, pp. 434-441 [8 page(s) (article)] (49 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott Williams & Wilkins, Hagerstown, MD, ETATS-UNIS  (1951) (Revue)

Mots-clés anglais / English Keywords

Arrhythmia

;

Excitability disorder

;

Heart disease

;

Cardiovascular disease

;

Human

;

Asystole

;

Nervous system diseases

;

Mots-clés français / French Keywords

Trouble rythme cardiaque

;

Trouble excitabilité

;

Cardiopathie

;

Appareil circulatoire pathologie

;

Homme

;

Asystolie

;

Système nerveux pathologie

;

Mots-clés espagnols / Spanish Keywords

Arritmia

;

Trastorno excitabilidad

;

Cardiopatía

;

Aparato circulatorio patología

;

Hombre

;

Asistolia

;

Sistema nervioso patología

;

Localisation / Location

INIST-CNRS, Cote INIST : 6345, 35400015002331.0050