Heart versus brain: a case of ictal asystole in temporal lobe epilepsy

The Egyptian Journal of Neurology, Psychiatry and Neurosurgery

article

Yassin, Ahmed¹  Aldabbour, Belal¹  Bagić, Anto²  Urban, Alexandra² 

[1] Department of Neurosciences, Neurology Division, King Abdullah University Hospital (KAUH);Department of Neurology, Epilepsy Division, University of Pittsburgh Medical School and UPMC

关键词: Ictal asystole;    Ictal bradycardia;    Arrhythmia;    Focal epilepsy;   

DOI  :  10.1186/s41983-020-0152-1

学科分类：医学（综合）

来源: Springer

【 摘 要 】

Ictal asystole is a rare phenomenon. Most reported cases are in persons with long-standing focal epilepsy originating from the temporal lobe. Its occurrence may complicate the clinical presentation or delay diagnosis, and it is thought to be associated with increased risk of sudden unexpected death in epilepsy. We report the case of a 55-year-old female person with epilepsy who suffered ictal asystole for 10 s while under monitoring at the Epilepsy Monitoring Unit. We then review briefly the pathophysiology and current management modalities for this phenomenon. The first step in management of this condition is usually the optimization of anti-seizure drugs. In our case, a 2-year fall-free period was achieved with optimization of medical treatment. Pacemaker implantation can also be attempted to prevent ictal asystole-related falls and injury, while refractory cases may benefit from epilepsy surgery in terms of both seizure control and prevention of ictal asystole.

【 授权许可】

CC BY