Ictal Asystole in Drug-Resistant Focal Epilepsy: Two Decades of Experience from an Epilepsy Monitoring Unit

Brain Sciences

Carlo Di Bonaventura¹  Luigi Pavone²  Sara Casciato²  Giancarlo Di Gennaro²  PierPaolo Quarato²  Alfredo D’Aniello²  Addolorata Mascia²  Vincenzo Esposito²  Roberta Morace²  Giovanni Assenza³  Mario Tombini³ 

[1] Epilepsy Unit, Department of Human Neurosciences, Policlinico “Umberto I”, “Sapienza” University, 00185 Rome, Italy;IRCCS NEUROMED, 86077 Pozzilli (IS), Italy;Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico, 00185 Rome, Italy;

关键词: video-EEG monitoring;    ictal asystole;    temporal lobe epilepsy;    cardiac pacemaker;    syncope;   

DOI  :  10.3390/brainsci10070443

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown