https://sudepwiki.pathology.jhmi.edu/index.php?title=Relation_between_ictal_asystole_and_cardiac_sympathetic_dysfunction_shown_by_MIBG-SPECT&feed=atom&action=historyRelation between ictal asystole and cardiac sympathetic dysfunction shown by MIBG-SPECT - Revision history2024-03-28T13:16:02ZRevision history for this page on the wikiMediaWiki 1.35.0https://sudepwiki.pathology.jhmi.edu/index.php?title=Relation_between_ictal_asystole_and_cardiac_sympathetic_dysfunction_shown_by_MIBG-SPECT&diff=1630&oldid=prevAlano at 17:53, 17 June 20192019-06-17T17:53:02Z<p></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 17:53, 17 June 2019</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l1" >Line 1:</td>
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<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">''Kerling F, Dütsch M, Linke R, Kuwert T, Stefan H, and Hilz MJ (2009) Relation between ictal asystole and cardiac sympathetic dysfunction shown by MIBG-SPECT. Acta Neurol Scand 120:2 123–9.''</del></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">{{Reference</ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">'''[http://onlinelibrary.wiley.com.ezp.welch.jhmi.edu/store/10.1111/j.1600-0404.2008.01135.x/asset/j.1600-0404.2008.01135.x.pdf?v</del>=<del class="diffchange diffchange-inline">1&t=j5pnpkal&s=362e1d8c125d19da38fa1cebe7725b0e1597d497 Link to Article]'''</del></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">|reference</ins>=</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">'''Abstract:''' OBJECTIVE: Tachyarrhythmias are common during epileptic seizures while bradyarrhythmias or asystoles are less frequent. Ictal asystole might be related to epilepsy-induced cardiac sympathetic denervation. METHODS: To evaluate cardiac post-ganglionic denervation in epilepsy patients with ictal asystoles we assessed I123-meta-iodobenzylguanidine (MIBG) as a marker of post-ganglionic cardiac norepinephrine-uptake</del>, <del class="diffchange diffchange-inline">using single photon emission computed tomography (MIBG-SPECT). RESULTS: In five of 844 patients with presurgical video-electroencephalography-monitoring</del>, <del class="diffchange diffchange-inline">we recorded ictal asystoles during nine of 37 seizures. Asystole patients underwent cardiologic examination (Holter-electrocardiogram</del>, <del class="diffchange diffchange-inline">echocardiogram) </del>and <del class="diffchange diffchange-inline">cardiac MIBG-SPECT. We compared cardiac MIBG uptake in the asystole patients to the uptake in 18 temporal lobe epilepsy </del>(<del class="diffchange diffchange-inline">TLE</del>) <del class="diffchange diffchange-inline">patients without bradyarrhythmias </del>and <del class="diffchange diffchange-inline">in 14 controls without </del>cardiac <del class="diffchange diffchange-inline">or neurological disease. As the cardiological examinations were unremarkable in all subjects, the heart/mediastinum-</del>MIBG-<del class="diffchange diffchange-inline">uptake ratios (H/M-ratios) differed significantly between the three groups (P = 0.004)</del>. <del class="diffchange diffchange-inline">H/M-ratios were lower in asystole TLE patients (mean +/- SD</del>: <del class="diffchange diffchange-inline">1.58 +/- 0.3) than in patients without asystole (1.81 +/- 0.18; P = 0.037) or controls (1.96 +/- 0.16). CONCLUSIONS: Pronounced reduction in cardiac MIBG uptake of asystole patients indicates post-ganglionic cardiac catecholamine disturbance. Impaired sympathetic cardiac innervation limits adjustment and heart rate modulation, and may increase the risk of asystole and ultimately sudden unexpected death in epilepsy (SUDEP)</del>.</div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">Kerling F, Dütsch M, Linke R</ins>, <ins class="diffchange diffchange-inline">Kuwert T</ins>, <ins class="diffchange diffchange-inline">Stefan H</ins>, and <ins class="diffchange diffchange-inline">Hilz MJ </ins>(<ins class="diffchange diffchange-inline">2009</ins>) <ins class="diffchange diffchange-inline">Relation between ictal asystole </ins>and cardiac <ins class="diffchange diffchange-inline">sympathetic dysfunction shown by </ins>MIBG-<ins class="diffchange diffchange-inline">SPECT</ins>. <ins class="diffchange diffchange-inline">Acta Neurol Scand 120</ins>:<ins class="diffchange diffchange-inline">2 123–9</ins>.</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">'''Keywords:''' asystole; temporal lobe epilepsy; cardiac MIBG-SPECT; sudden unexpected death in epilepsy; cardiac sympathetic denervation</del></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">|url=</ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>=<del class="diffchange diffchange-inline">Context</del>=</div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">http://onlinelibrary.wiley.com.ezp.welch.jhmi.edu/store/10.1111/j.1600-0404.2008.01135.x/asset/j.1600-0404.2008.01135.x.pdf?v</ins>=<ins class="diffchange diffchange-inline">1&t=j5pnpkal&s=362e1d8c125d19da38fa1cebe7725b0e1597d497</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">|abstract=</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">OBJECTIVE: Tachyarrhythmias are common during epileptic seizures while bradyarrhythmias or asystoles are less frequent. Ictal asystole might be related to epilepsy-induced cardiac sympathetic denervation. METHODS: To evaluate cardiac post-ganglionic denervation in epilepsy patients with ictal asystoles we assessed I123-meta-iodobenzylguanidine (MIBG) as a marker of post-ganglionic cardiac norepinephrine-uptake, using single photon emission computed tomography (MIBG-SPECT). RESULTS: In five of 844 patients with presurgical video-electroencephalography-monitoring, we recorded ictal asystoles during nine of 37 seizures. Asystole patients underwent cardiologic examination (Holter-electrocardiogram, echocardiogram) and cardiac MIBG-SPECT. We compared cardiac MIBG uptake in the asystole patients to the uptake in 18 temporal lobe epilepsy (TLE) patients without bradyarrhythmias and in 14 controls without cardiac or neurological disease. As the cardiological examinations were unremarkable in all subjects, the heart/mediastinum-MIBG-uptake ratios (H/M-ratios) differed significantly between the three groups (P = 0.004). H/M-ratios were lower in asystole TLE patients (mean +/- SD: 1.58 +/- 0.3) than in patients without asystole (1.81 +/- 0.18; P = 0.037) or controls (1.96 +/- 0.16). CONCLUSIONS: Pronounced reduction in cardiac MIBG uptake of asystole patients indicates post-ganglionic cardiac catecholamine disturbance. Impaired sympathetic cardiac innervation limits adjustment and heart rate modulation, and may increase the risk of asystole and ultimately sudden unexpected death in epilepsy (SUDEP).</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">|keywords=</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">asystole; temporal lobe epilepsy; cardiac MIBG-SPECT; sudden unexpected death in epilepsy; cardiac sympathetic denervation</ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">|context</ins>=</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*Original, prospective study of symapthetic nervous system input to the heart in epileptic patients with a history of asystole. Among 844 patients undergoing presurgical monitoring, 5 patients suffered a total of 37 seizures. All were adults and 4 of 5 were male, and all were on AED. The latency between seizure onset and asystole was 30 - 50 s, with aystole lasting 10 - 30 s. In the two seizure types that lateralized, left temporal and right temporal loci were observed. All suffered from TLE or MTLE. MIBG was used to infer the amount of norepinephrine taken up in the heart relative to the mediastinum, used as a background tissue. All temporal lobe epilepsy patients (5 with asystole and 18 without) had a trend for a lower uptake ratio than controls, and asystole patients were significantly lower than the other two groups.</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*Original, prospective study of symapthetic nervous system input to the heart in epileptic patients with a history of asystole. Among 844 patients undergoing presurgical monitoring, 5 patients suffered a total of 37 seizures. All were adults and 4 of 5 were male, and all were on AED. The latency between seizure onset and asystole was 30 - 50 s, with aystole lasting 10 - 30 s. In the two seizure types that lateralized, left temporal and right temporal loci were observed. All suffered from TLE or MTLE. MIBG was used to infer the amount of norepinephrine taken up in the heart relative to the mediastinum, used as a background tissue. All temporal lobe epilepsy patients (5 with asystole and 18 without) had a trend for a lower uptake ratio than controls, and asystole patients were significantly lower than the other two groups.</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>=<del class="diffchange diffchange-inline">Comments=</del></div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">|comments</ins>=</div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">}}</ins></div></td></tr>
</table>Alanohttps://sudepwiki.pathology.jhmi.edu/index.php?title=Relation_between_ictal_asystole_and_cardiac_sympathetic_dysfunction_shown_by_MIBG-SPECT&diff=982&oldid=prevTest at 01:08, 28 June 20182018-06-28T01:08:41Z<p></p>
<table class="diff diff-contentalign-left diff-editfont-monospace" data-mw="interface">
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<col class="diff-content" />
<tr class="diff-title" lang="en">
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 01:08, 28 June 2018</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l9" >Line 9:</td>
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<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>=Context=</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>=Context=</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*Original, prospective study of symapthetic nervous system input to the heart in epileptic patients with a history of asystole. Among 844 patients undergoing presurgical monitoring, 5 patients suffered a total of 37 seizures. All were adults and 4 of 5 were male, and all were on AED. <del class="diffchange diffchange-inline">The </del>latency between seizure onset and asystole was 30 - 50 s, with aystole lasting 10 - 30 s. In the two seizure types that lateralized, left temporal and right temporal loci were observed. All suffered from TLE or MTLE. MIBG was used to infer the amount of norepinephrine taken up in the heart relative to the mediastinum, used as a background tissue. All temporal lobe epilepsy patients (5 with asystole and 18 without) had a trend for a lower uptake ratio than controls, and asystole patients were significantly lower than the other two groups.</div></td><td class='diff-marker'>+</td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*Original, prospective study of symapthetic nervous system input to the heart in epileptic patients with a history of asystole. Among 844 patients undergoing presurgical monitoring, 5 patients suffered a total of 37 seizures. All were adults and 4 of 5 were male, and all were on AED. <ins class="diffchange diffchange-inline">The </ins>latency between seizure onset and asystole was 30 - 50 s, with aystole lasting 10 - 30 s. In the two seizure types that lateralized, left temporal and right temporal loci were observed. All suffered from TLE or MTLE. MIBG was used to infer the amount of norepinephrine taken up in the heart relative to the mediastinum, used as a background tissue. All temporal lobe epilepsy patients (5 with asystole and 18 without) had a trend for a lower uptake ratio than controls, and asystole patients were significantly lower than the other two groups.</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>=Comments=</div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>=Comments=</div></td></tr>
</table>Testhttps://sudepwiki.pathology.jhmi.edu/index.php?title=Relation_between_ictal_asystole_and_cardiac_sympathetic_dysfunction_shown_by_MIBG-SPECT&diff=450&oldid=prevYcarmen1: Created page with "''Kerling F, Dütsch M, Linke R, Kuwert T, Stefan H, and Hilz MJ (2009) Relation between ictal asystole and cardiac sympathetic dysfunction shown by MIBG-SPECT. Acta Neurol Sc..."2017-07-29T18:56:22Z<p>Created page with "''Kerling F, Dütsch M, Linke R, Kuwert T, Stefan H, and Hilz MJ (2009) Relation between ictal asystole and cardiac sympathetic dysfunction shown by MIBG-SPECT. Acta Neurol Sc..."</p>
<p><b>New page</b></p><div>''Kerling F, Dütsch M, Linke R, Kuwert T, Stefan H, and Hilz MJ (2009) Relation between ictal asystole and cardiac sympathetic dysfunction shown by MIBG-SPECT. Acta Neurol Scand 120:2 123–9.''<br />
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'''[http://onlinelibrary.wiley.com.ezp.welch.jhmi.edu/store/10.1111/j.1600-0404.2008.01135.x/asset/j.1600-0404.2008.01135.x.pdf?v=1&t=j5pnpkal&s=362e1d8c125d19da38fa1cebe7725b0e1597d497 Link to Article]'''<br />
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'''Abstract:''' OBJECTIVE: Tachyarrhythmias are common during epileptic seizures while bradyarrhythmias or asystoles are less frequent. Ictal asystole might be related to epilepsy-induced cardiac sympathetic denervation. METHODS: To evaluate cardiac post-ganglionic denervation in epilepsy patients with ictal asystoles we assessed I123-meta-iodobenzylguanidine (MIBG) as a marker of post-ganglionic cardiac norepinephrine-uptake, using single photon emission computed tomography (MIBG-SPECT). RESULTS: In five of 844 patients with presurgical video-electroencephalography-monitoring, we recorded ictal asystoles during nine of 37 seizures. Asystole patients underwent cardiologic examination (Holter-electrocardiogram, echocardiogram) and cardiac MIBG-SPECT. We compared cardiac MIBG uptake in the asystole patients to the uptake in 18 temporal lobe epilepsy (TLE) patients without bradyarrhythmias and in 14 controls without cardiac or neurological disease. As the cardiological examinations were unremarkable in all subjects, the heart/mediastinum-MIBG-uptake ratios (H/M-ratios) differed significantly between the three groups (P = 0.004). H/M-ratios were lower in asystole TLE patients (mean +/- SD: 1.58 +/- 0.3) than in patients without asystole (1.81 +/- 0.18; P = 0.037) or controls (1.96 +/- 0.16). CONCLUSIONS: Pronounced reduction in cardiac MIBG uptake of asystole patients indicates post-ganglionic cardiac catecholamine disturbance. Impaired sympathetic cardiac innervation limits adjustment and heart rate modulation, and may increase the risk of asystole and ultimately sudden unexpected death in epilepsy (SUDEP).<br />
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'''Keywords:''' asystole; temporal lobe epilepsy; cardiac MIBG-SPECT; sudden unexpected death in epilepsy; cardiac sympathetic denervation<br />
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*Original, prospective study of symapthetic nervous system input to the heart in epileptic patients with a history of asystole. Among 844 patients undergoing presurgical monitoring, 5 patients suffered a total of 37 seizures. All were adults and 4 of 5 were male, and all were on AED. The latency between seizure onset and asystole was 30 - 50 s, with aystole lasting 10 - 30 s. In the two seizure types that lateralized, left temporal and right temporal loci were observed. All suffered from TLE or MTLE. MIBG was used to infer the amount of norepinephrine taken up in the heart relative to the mediastinum, used as a background tissue. All temporal lobe epilepsy patients (5 with asystole and 18 without) had a trend for a lower uptake ratio than controls, and asystole patients were significantly lower than the other two groups.<br />
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=Comments=</div>Ycarmen1