Epileptic seizures associated with syncope: Ictal bradycardia and ictal asystole

Monté, C.P.J.A.; Monté, Carlos Jules; Boon, Paul; Arends, Johan

doi:10.1016/j.yebeh.2018.10.027

Cited by 23 publications

(24 citation statements)

References 20 publications

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“…IA can be classified as early or late-onset. Late-onset IA is defined as asystole that occurs within 30 seconds after the onset of the electrographic seizure [30] . Latency of IA may have lateralizing value, early onset IA was associated with temporal lobe epilepsy; four out of five of our patients with early onset had left temporal lobe seizure while the fifth had a right temporal onset.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ictal asystole during long-term video-EEG; semiology, localization, and intervention

Khalil¹,

Shukralla²,

Kilbride³

et al. 2021

Epilepsy & Behavior Reports

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Section: Discussionmentioning

confidence: 99%

“…Five patients had late-onset of IA defined by asystole that occurs 30 seconds after an electrographic change [30] . All five patients experience clinical syncope as part of their semiology.…”

Section: Introductionmentioning

confidence: 99%

Ictal asystole during long-term video-EEG; semiology, localization, and intervention

Khalil¹,

Shukralla²,

Kilbride³

et al. 2021

Epilepsy & Behavior Reports

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“…If clinicians can accurately and quickly identify the cause of syncope and give appropriate treatment, mortality can be reduced greatly. Monté et al [13] applied the traditional MC algorithm to CT images of 113 patients with PE and found that the reconstruction time of the traditional MC algorithm was longer. Sink et al [14] simplified the running time of MC algorithm in CT examination based on the grid, and the reconstruction effect was relatively ideal.…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Reconstruction Algorithm for CT Pulmonary Angiography in Patients with Pulmonary Embolism Combined with Syncope

Zhang¹,

Zhang²,

Wang³

et al. 2021

Scientific Programming

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This paper aimed to study the clinical characteristics of patients with pulmonary embolism (PE) with syncope (PE + S) based on the three-dimensional (3D) reconstruction algorithm in computed tomography (CT) pulmonary angiography (CTPA). In this study, 857 patients with acute PE (APE) who were treated in hospital were selected as the research objects and divided into syncope group (group S) and nonsyncope group (group NS). The 3D reconstruction marching cubes (3DR-MC) algorithm was compared with the traditional MC (T-MC) algorithm and the mesh simplification MC (MMS-MC) algorithm, and the results proved that the running time of the 3DR-MC algorithm on the platform was shorter than that of the other two algorithms. The incidence of syncope in group S in women was higher than that in group NS (51.7% vs. 38.2%). The incidence of syncope classified as high risk in group S was higher than that in group NS, and the mortality rate of pulmonary embolism patients with syncope was higher, and the difference was statistically significant (χ2 = 113.332, P < 0.05 ). The incidence of syncope in group S was higher than that in group NS (χ2 = 4.074, P < 0.05 ). In short, hypertension was an independent risk factor for syncope. PE + S patients could be diagnosed and treated as early as possible based on the clinical characteristics, so as to reduce the adverse consequences of misdiagnosis.

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“…Besides the aforementioned cardiorespiratory outcomes, there have also been reports on other rare but serious outcomes such as ictal bradycardia and ictal asystole in epileptic patients (Monte et al., 2019; Nguyen‐Michel et al., 2014). These ictal outcomes tend to occur with cerebral hypoperfusion symptoms such as pallor, atonia, early myoclonic jerks, loss of consciousness, hypertonia, and falling.…”

Section: Cardiorespiratory Findingsmentioning

confidence: 99%

“…These ictal outcomes tend to occur with cerebral hypoperfusion symptoms such as pallor, atonia, early myoclonic jerks, loss of consciousness, hypertonia, and falling. Secondarily, they also may progress with symptoms associated with cerebral reperfusion, including skin flushing and late myoclonic jerks (Nguyen‐Michel et al., 2014), and have shown to occur following a decrease in heart rate during focal seizures (Monte et al., 2019). Even though ictal cardiorespiratory outcomes are rare in epileptic patients, they still may play a role in some cases of SUDEP, and thus should equally be investigated in future studies.…”

Section: Cardiorespiratory Findingsmentioning

confidence: 99%

Cardiorespiratory findings in epilepsy: A recent review on outcomes and pathophysiology

Akyüz

Uner

Köklü

et al. 2021

J of Neuroscience Research

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Epilepsy is a debilitating disorder of uncontrollable recurrent seizures that occurs as a result of imbalances in the brain excitatory and inhibitory neuronal signals, that could stem from a range of functional and structural neuronal impairments. Globally, nearly 70 million people are negatively impacted by epilepsy and its comorbidities. One such comorbidity is the effect epilepsy has on the autonomic nervous system (ANS), which plays a role in the control of blood circulation, respiration and gastrointestinal function. These epilepsy‐induced impairments in the circulatory and respiratory systems may contribute toward sudden unexpected death in epilepsy (SUDEP). Although, various hypotheses have been proposed regarding the role of epilepsy on ANS, the linking pathological mechanism still remains unclear. Channelopathies and seizure‐induced damages in ANS‐control brain structures were some of the causal/pathological candidates of cardiorespiratory comorbidities in epilepsy patients, especially in those who were drug resistant. However, emerging preclinical research suggest that neurotransmitter/receptor dysfunction and synaptic changes in the ANS may also contribute to the epilepsy‐related autonomic disorders. Thus, pathological mechanisms of cardiorespiratory dysfunction should be elucidated by considering the modifications in anatomy and physiology of the autonomic system caused by seizures. In this regard, we present a comprehensive review of the current literature, both clinical and preclinical animal studies, on the cardiorespiratory findings in epilepsy and elucidate the possible pathological mechanisms of these findings, in hopes to prevent SUDEP especially in patients who are drug resistant.

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Epileptic seizures associated with syncope: Ictal bradycardia and ictal asystole

Cited by 23 publications

References 20 publications

Ictal asystole during long-term video-EEG; semiology, localization, and intervention

Ictal asystole during long-term video-EEG; semiology, localization, and intervention

Three-Dimensional Reconstruction Algorithm for CT Pulmonary Angiography in Patients with Pulmonary Embolism Combined with Syncope

Cardiorespiratory findings in epilepsy: A recent review on outcomes and pathophysiology

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