Cardiac asystole in partial seizures

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Scott CA and Fish DR (2000) Cardiac asystole in partial seizures. Epileptic Disord 2:2 89–92.

Link to Article

Abstract: Literature review shows many anecdotal case reports of cardiac asystole in ictal recordings of partial seizures. We have reviewed our data from the last five years, of patients who are being assessed for epilepsy surgery and found 2 out of more than 1,500 complex partial seizures, recorded in 589 consecutive patients, showing a significant period of asystole (13 and 15 seconds). Our previous studies of cardiac and respiratory parameters during partial seizures showed that a central apnoea occurred in 39%. It is probable that sudden death during seizures is due to the interaction of both cardiac and respiratory irregularities. Although rare (occurrence < 0.15%), the possibility of cardiac asystole occurring in an epilepsy monitoring unit highlights the need for resuscitation equipment to be readily available and for trained nursing staff. Furthermore, it is important to recognize that the semiology of seizures may be affected by the consequences of secondary cardiac asystole.

Context

  • Retrospective study of video EEG records of > 1,500 complex partial seizures recorded in almost 600 patients that found 2 instances of asystole, lasting 13 and 15 seconds. In one of the 2 seizures, the authors point out, jerking movements that occur after the asystole may be related to cerebral hypoperfusion rather than to seizure activity per se. Also refers to previous work identifying central apnea during nearly 40% of partial seizures.

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