Resolution of ictal bradycardia and asystole following temporal lobectomy: A case report, and review of available cases using pacemakers

Ballendine, Stephanie A.; Shahab, Izn; Perez-Careta, Mitzel; Taveras-Almonte, Francisco J.; Martínez‐Juárez, Iris E.; Hernández-Vanegas, Laura E.; Dolinsky, Chelsea; Wu, Aihua; Téllez‐Zenteno, José F.

doi:10.1016/j.ebr.2019.100333

Cited by 5 publications

(2 citation statements)

References 50 publications

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“…Notably, resolution of ictal bradycardia and asystole after temporal lobectomy has been demonstrated. 34 Ictal bradycardia/asystole may contribute to SUDEP, whereby detection of patients exhibiting these cardiovascular symptoms in association with focal seizures could guide life-saving preventative treatment, such as pacemaker placement. 35 The patient we detailed in this study thankfully received a pacemaker, which, while not curative for her epilepsy, did prevent the LOC portion of her seizures for many years before her epilepsy worsened.…”

Section: Discussionmentioning

confidence: 99%

Epileptic Seizure Induced by Head-Up Tilt: A Case Series Study

Toprani

Jaradeh²,

Falco-Walter³

2022

Journal of Clinical Neurophysiology

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Purpose: Epilepsy and syncope can be difficult to distinguish, with misdiagnosis resulting in unnecessary or incorrect treatment and disability. Combined tilt-table and video EEG (vEEG) testing (tilt-vEEG) is infrequently used to parse these entities even at large centers. Because of the discovery of a rare case of epileptic seizure induced by head-up tilt (HUT) (no prior cases have been published), the authors sought to verify the rarity of this phenomenon.

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Section: Discussionmentioning

confidence: 99%

Epileptic Seizure Induced by Head-Up Tilt: A Case Series Study

Toprani

Jaradeh²,

Falco-Walter³

2022

Journal of Clinical Neurophysiology

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“…Pacemaker implantation can be reserved for those who fail to become fall-free on ASDs alone [18]. Cases of drug-resistant epilepsy associated with IA might benefit from epilepsy surgery in terms of both seizure control and prevention of IA [14,18,20,21].…”

Section: Discussionmentioning

confidence: 99%

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

Yassin

Aldabbour

Bagić

et al. 2020

Egypt J Neurol Psychiatry Neurosurg

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Background: Ictal asystole is a rare phenomenon. Most reported cases are in persons with long-standing focal epilepsy originating from the temporal lobe. Its occurrence may complicate the clinical presentation or delay diagnosis, and it is thought to be associated with increased risk of sudden unexpected death in epilepsy. Case presentation: We report the case of a 55-year-old female person with epilepsy who suffered ictal asystole for 10 s while under monitoring at the Epilepsy Monitoring Unit. We then review briefly the pathophysiology and current management modalities for this phenomenon. Discussion: The first step in management of this condition is usually the optimization of anti-seizure drugs. In our case, a 2-year fall-free period was achieved with optimization of medical treatment. Pacemaker implantation can also be attempted to prevent ictal asystole-related falls and injury, while refractory cases may benefit from epilepsy surgery in terms of both seizure control and prevention of ictal asystole.

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Ictal Asystole During Focal Seizures Due to Left Occipital Glioneuronal Tumor: A Report of Case Treated With Cardiac Neuromodulation

Guney,

Demirel,

Celebi

et al. 2024

Clin EEG Neurosci

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Ictal asystole (IA) is a rare but potentially life-threatening complication of focal epilepsy. The sudden onset of loss of consciousness and drop attacks in a patient with chronic epilepsy should suggest the possibility of this complication. Once the diagnosis is established, rapid management should be considered, especially in high-risk cases. The approach does not differ between temporal and extratemporal lobe epilepsies. Strategies can be aimed at preventing the emergence of cortical epileptic activity from the beginning (surgery, antiseizure therapy), neutralizing negative chronotropic effects on the heart (cardiac neuromodulation), or restarting the heart rhythm with a pacemaker. Pacemaker implantation is not a completely complication-free treatment, and living with a device that requires care and follow-up throughout life makes alternative treatment methods more valid for young patients with many years to live or cases that could benefit from surgery. In this article, we present a patient with a left occipital glioneuronal tumor and drug-resistant occipital lobe epilepsy. IA was documented by long-term video EEG monitoring (VEM). During about 2 years of follow-up after a cardiac neuromodulation procedure, there were no drop attacks or asystole with seizures, confirmed by long-term VEM.

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Resolution of ictal bradycardia and asystole following temporal lobectomy: A case report, and review of available cases using pacemakers

Cited by 5 publications

References 50 publications

Epileptic Seizure Induced by Head-Up Tilt: A Case Series Study

Epileptic Seizure Induced by Head-Up Tilt: A Case Series Study

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

Ictal Asystole During Focal Seizures Due to Left Occipital Glioneuronal Tumor: A Report of Case Treated With Cardiac Neuromodulation

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