We describe the clinical and neurophysiological features of four patients with cardiac asystole during partial seizures before and after pace-maker implantation. Among patients who underwent prolonged Video-EEG (VEEG) monitoring for drug-resistant epilepsy from January 2004 to December 2010, we selected cases in which cardiac asystole was recorded during at least one seizure. We selected 4 cases (3.9 %) with cardiac asystole, (2 men), mean age 32 years (range 21-40). VEEG, cardiologic examination, brain magnetic resonance imaging (MRI), head-up tilt test and continuous heart rate/blood pressure monitoring were performed in all patients. These four patients had drug-resistant partial epilepsy originating from the bitemporal lobes in two cases, the right frontal regions in one case and right fronto-temporal regions in one case. Brain MRI in two cases was unremarkable whereas it disclosed left mesial temporal sclerosis in one patient and left amigdala dysplasia in another. Average length of the ictal asystolia was 11.9 secs (range 5.5-20). All investigations ruled out the cardiac origin of the asystolia. For these reasons a cardiac demand stimulator was implanted in all cases. Since pace-maker implantation, the seizures occur in all patients with the same frequency and semeiological features without asystolia or loss of consciousness.
|Translated title of the contribution||Ictal asystole: Description of four cases before and after pace-maker implantation|
|Number of pages||2|
|Journal||Bollettino - Lega Italiana contro l'Epilessia|
|Publication status||Published - Apr 2013|
ASJC Scopus subject areas
- Clinical Neurology