Potentially high-risk cardiac arrhythmias with focal to bilateral tonic–clonic seizures and generalized tonic–clonic seizures are associated with the duration of periictal hypoxemia

Park KJ, Sharma G, Kennedy JD, and Seyal M (2017): Potentially high-risk cardiac arrhythmias with focal to bilateral tonic–clonic seizures and generalized tonic–clonic seizures are associated with the duration of periictal hypoxemia. Epilepsia 58:12 2164-2171

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Overview: To investigate potentially high-risk cardiac arrhythmias (PHAs) following focal to bilateral tonic–clonic seizures (FBTCSs) and generalized tonic–clonic seizures (GTCSs) and to study the association of PHAs with seizure characteristics and the severity of associated ictal respiratory dysfunction.

Context

• This study looked at data from 69 patients with focal to bilateral tonic-clonic or generalized tonic-clonic seizures. The data included video-EEG recordings, EKG, and SpO2 levels. They characterized potentially high-risk cardiac arrhythmias (PHAs) as "nonsustained ventricular tachycardia, bradyarrhytmia, and/or sinus pauses". Following evaluation of these patients they found that following a FBTC or GTC seizure, there was a state of hypoxemia during the ictal/postictal state. These seizures events associated with hypoxemia could lead to fatal cardiac arrhythmias and a higher risk of sudden death. These findings build off of Blum AS et al 2000 who explored SpO2 levels during partial seizures, but did not investigate heart abnormalities during seizure events.