Cardiac arrest associated with epileptic seizures: A case report with simultaneous EEG and ECG

Abstract

Ictal asystole is a rare, probably underestimated manifestation of epileptic seizures whose pathophysiology is still debated. This report describes two patients who had cardiac asystole at the end of their seizure. The first patient was a 13-year-old boy with complex partial seizures.. His MRI showed symmetrical signal abnormality in the bilateral parietooccipital lobe accompanied by mild gliosis and volume loss. During a 3-day long-term video-EEG monitoring, he had cardiac arrest at the end of one of his seizures that was secondarily generalized. The second one was a 42-year-old veteran with penetrating head trauma in the left frontal lobe due to shell injury. During long-term video-EEG monitoring, he had one generalized tonic–clonic seizure accompanied by bradycardia and cardiac asystole. Asystoles could have a role in the incidence of sudden unexpected death in epilepsy (SUDEP), meaning that the presence of ictal bradycardia is a risk factor for SUDEP. In cases of epileptic cardiac dysrhythmia, prolonged simultaneous EEG/ECG monitoring may be required. Cardiological investigation should be included in epilepsy management.

Etiology of Sudden Cardiac Arrest in Patients with Epilepsy: Experience of Tertiary Referral Hospital in Sapporo City, Japan

“…In previous research on SUDEP, cardiac arrhythmia subsequent to ictus as well as either central or obstructive hypoventilation induced by seizure is focused through the autonomic nervous system. 19 – 21) Incomplete asphyxia was implicated as the cause of SUDEP in three of five cases, but we could not confirm the characteristic abnormality in the electrocardiograms that had been taken after resuscitation. Increased risks associated with SUDEP generally involve male patients, a younger age at epilepsy-onset, longer disease duration, mental retardation, and high frequency of GTCS.…”

Fabrication of Flexible and Conductive Microneedle Array Electrodes from Silk Fibroin by Mesoscopic Engineering

“…Electrophysiological signals like ECG and electromyography (EMG) play a crucial role in medical diagnoses, [ 1 ] such as cardiovascular diseases and skeletal muscle abnormalities. [ 1c,2 ] Therefore, wearable long‐lasting electrodes with optimal mechanical and electrical properties are essential. [ 3 ] Superior biocompatibility and skin compatibility are crucial for long‐term monitoring.…”