Heart versus brain: a case of ictal asystole in temporal lobe epilepsy

Yassin, Ahmed; Aldabbour, Belal; Bagić, Anto; Urban, Alexandra

doi:10.1186/s41983-020-0152-1

Cited by 3 publications

(1 citation statement)

References 21 publications

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“…Although some studies investigated EKG monitoring's value during prolonged EEG [16][17][18][19], the literature on utilizing EKG during routine/short EEG in diagnosing arrhythmia is scarce [3,20]. This study investigates the frequency and types of EKG abnormalities during routine EEG recording and its diagnostic value.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of electrocardiogram during routine electroencephalogram

Yassin

El‐Salem

Khassawneh

et al. 2021

Seizure

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Section: Introductionmentioning

confidence: 99%

Diagnostic value of electrocardiogram during routine electroencephalogram

Yassin

El‐Salem

Khassawneh

et al. 2021

Seizure

Self Cite

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ER and doctors’ preparedness to manage status epilepticus: a multi-institutional survey from the Gaza Strip

Aldabbour,

AbuNemer,

Alfarra

et al. 2024

BMC Health Serv Res

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Background Status epilepticus (SE) is a top neurological and medical emergency. Adequate staff knowledge and sufficient hospital resources are mandatory for timely management and better outcomes. This study aims to evaluate Palestinian ER doctors’ knowledge and beliefs towards SE and assess the state and availability of hospital resources needed to manage SE appropriately. Methods This cross-sectional study surveyed all ER doctors working in the six governmental hospitals in the Gaza Strip during June 2022. A questionnaire assessed the knowledge and beliefs toward SE and the practice of SE knowledge acquisition. Simultaneous field surveys determined the availability of essential medications and resources at each hospital and doctors’ actual awareness about the status of these resources. Linear regression determined predictors of higher knowledge scores. Results 137 doctors participated (response rate 81%). Most were males, had graduated within six years of data collection, and 45.3% worked at Shifa Medical Complex. 63.5% of participants recognized the correct operational definition of status epilepticus. 85.4 and 83.9% recognized that it might cause permanent brain damage or death, respectively. Only 10.9% recognized the average mortality rate of a single convulsive SE episode. 44.5% believed that awaiting spontaneous SE resolution is a valid approach to management. Significant defects were noted in the awareness of subclinical SE, including its recognition and prevalence in ciritcally ill patients. Having a higher qualification and graduating from local medical schools predicted higher scores. In field surveys, EEG was unavailable at all hospitals, while CT scans and a neurologist physician were unavailable at two hospitals. IV phenytoin was the only second-line treatment available at all hospitals. IV valproate and levetiracetam were universally unavailable. Conclusions The survey revealed significant defects in Palestinian ER doctors’ knowledge and beliefs towards SE. Several hospitals also demonstrated a critical lack of resources to manage this condition appropriately. This should be addressed by the local health authorities to avoid potentially preventable SE-related mortality and morbidity. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-024-11792-5.

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A Case Report of Ictal Bradycardia and Asystole

Pamecha

Jayabalan

Nallaswamy

2021

International Journal of Heart Rhythm

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The ictal bradycardia syndrome occurs when epileptic discharges disrupt normal cardiac rhythms leading to a reduction of heart rate that is more than 10 beats/min below the baseline. Mostly documented ictal bradycardias are accompanied by complex partial seizures of temporal lobe origin. Sudden unexpected death in epilepsy is often assumed to be associated with a concomitant seizure, but it is almost impossible to prove conclusively. Here, we report the case of a 52-year-old female patient admitted with the complaints of two episodes of generalized tonic–clonic seizures and vomiting followed by presyncope and syncope. The patient was admitted in a drowsy disoriented state with hypotension and electrocardiogram (ECG) illustrating sinus tachycardia. Later during admission, the patient developed complex focal seizures with secondary generalization and cardiac arrest. During video electroencephalogram/ECG, she had another similar episode and cardiac arrest. ECG showed rapid progression to asystole and ventricular pause of 25 s followed by complete heart block with ventricular escape rhythm of 17 beats/min. She was implanted with a temporary pacemaker but later during the hospitalization, sudden unexpected death in epilepsy occurred in spite of cardiac pacing and optimum antiepileptic medication. Most documented pauses are of nonlife-threatening duration (range 3–20 s) with longer pauses being observed. Cardiac pacing may help to reduce the risk of falls, but in the absence of official practice guidelines, cardiac pacing should only be considered for patients in whom conventional antiepileptic therapy has failed to prevent ictal asystole. Early diagnosis, interventions, and optimum antiepileptic dose escalation with occasional epilepsy surgery are the mainstay to prevent mortality and severe prognosis of the ictal bradycardia syndrome.

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Heart versus brain: a case of ictal asystole in temporal lobe epilepsy

Cited by 3 publications

References 21 publications

Diagnostic value of electrocardiogram during routine electroencephalogram

Diagnostic value of electrocardiogram during routine electroencephalogram

ER and doctors’ preparedness to manage status epilepticus: a multi-institutional survey from the Gaza Strip

A Case Report of Ictal Bradycardia and Asystole

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