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

Sara Casciato; Pier Paolo Quarato; Addolorata Mascia; Alfredo D'Aniello; Vincenzo Esposito; Roberta Morace; Luigi Pavone; Carlo Di Bonaventura; Mario Tombini; Giovanni Assenza; Giancarlo Di Gennaro

doi:10.3390/brainsci10070443

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

Sara Casciato, Pier Paolo Quarato, Addolorata Mascia, Alfredo D'Aniello, Vincenzo Esposito, Roberta Morace, Luigi Pavone, Carlo Di Bonaventura, Mario Tombini, Giovanni Assenza, Giancarlo Di Gennaro

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Abstract

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.

Original language	English
Journal	Brain Sciences
Volume	10
Issue number	7
DOIs	https://doi.org/10.3390/brainsci10070443
Publication status	Published - Jul 12 2020

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Ictal Asystole in Drug-Resistant

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Ictal Asystole in Drug-Resistant Focal Epilepsy : Two Decades of Experience from an Epilepsy Monitoring Unit. / Casciato, Sara; Quarato, Pier Paolo; Mascia, Addolorata ; D'Aniello, Alfredo ; Esposito, Vincenzo ; Morace, Roberta ; Pavone, Luigi; Di Bonaventura, Carlo; Tombini, Mario; Assenza, Giovanni; Di Gennaro, Giancarlo.

In: Brain Sciences, Vol. 10, No. 7, 12.07.2020.

Research output: Contribution to journal › Article › peer-review

Casciato, Sara ; Quarato, Pier Paolo ; Mascia, Addolorata ; D'Aniello, Alfredo ; Esposito, Vincenzo ; Morace, Roberta ; Pavone, Luigi ; Di Bonaventura, Carlo ; Tombini, Mario ; Assenza, Giovanni ; Di Gennaro, Giancarlo. / Ictal Asystole in Drug-Resistant Focal Epilepsy : Two Decades of Experience from an Epilepsy Monitoring Unit. In: Brain Sciences. 2020 ; Vol. 10, No. 7.

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

abstract = "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.",

author = "Sara Casciato and Quarato, {Pier Paolo} and Addolorata Mascia and Alfredo D'Aniello and Vincenzo Esposito and Roberta Morace and Luigi Pavone and {Di Bonaventura}, Carlo and Mario Tombini and Giovanni Assenza and {Di Gennaro}, Giancarlo",

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AU - Quarato, Pier Paolo

AU - Mascia, Addolorata

AU - D'Aniello, Alfredo

AU - Esposito, Vincenzo

AU - Morace, Roberta

AU - Pavone, Luigi

AU - Di Bonaventura, Carlo

AU - Tombini, Mario

AU - Assenza, Giovanni

AU - Di Gennaro, Giancarlo

PY - 2020/7/12

Y1 - 2020/7/12

N2 - 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.

AB - 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.

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DO - 10.3390/brainsci10070443

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