دورية أكاديمية

Epileptic seizures associated with syncope:ictal bradycardia and ictal asystole

التفاصيل البيبلوغرافية
العنوان: Epileptic seizures associated with syncope:ictal bradycardia and ictal asystole
المؤلفون: Monté, Carlos Paul, Monté, Carlos Jules, Boon, P Paul, Arends, JBAM Johan
المصدر: ISSN:1525-5050.
بيانات النشر: Academic Press Inc.
سنة النشر: 2019
المجموعة: Eindhoven University of Technology (TU/e): Research Portal
الوصف: Introduction: Heart rate decrease during epileptic seizures is rare and should be considered in patients with unusual or refractory episodes of syncope or in patients with a history suggestive of both epilepsy and syncope. We systematically reviewed the literature to better understand the clinical signs and risk factors of ictal heart rate decreases. Material and methods: We performed a literature-search on “ictal bradycardia” and “ictal asystole” in Pubmed and added papers from the references and personal archives. Articles relating to animal studies, seizures without ictal decrease of heart rate, cases without simultaneous electroencephalography (EEG) and electrocardiography (ECG), convulsive syncopes, or cases with bradycardia before seizure onset and articles written in other languages than English, Dutch, German, French, or Spanish were excluded. Full texts of the remaining articles were screened for cases of ictal bradycardia or ictal asystole. Cases were selected on the basis of a self-designed quality score. The relationship of RR wave interval of at least 5 s, signs of syncope, and EEG signs of ischemia were analyzed with chi-square test and identifying 95% confidence intervals. Results: Ictal bradycardia and ictal asystole predominantly occurred during focal seizures with loss of awareness (proportion in the combined group of bradycardia and asystole (p1 + 2) = 0.85) in people with mainly left lateralized (p1 + 2 = 0.64; p = 0.001) temporal lobe seizures (p1 + 2 = 0.91). Seizures with ictal asystole typically started with a heart rate decrease. During ictal asystole in the majority of cases, not only the clinical signs of syncope occurred (change of proportion (Δp) = 0.67; 95% CI: 0.48–0.86; p < 0.0001), i.e., interrupting the seizure semiology, but also the characteristic EEG signs of ischemia (Δp = 0.50; 95% CI: 0.26–0.74; p < 0.001). We found a statistically significant relation between signs of syncope and EEG signs of ischemia (Δp = − 0.37; 95% CI: (− 0.64)–(− 0.10); p < 0.01) but not ...
نوع الوثيقة: article in journal/newspaper
وصف الملف: application/pdf
اللغة: English
العلاقة: http://repository.tue.nl/908165Test
الإتاحة: http://repository.tue.nl/908165Test
حقوق: Copyright (c) Monté, Carlos Paul ; Copyright (c) Monté, Carlos Jules ; Copyright (c) Boon, P Paul ; Copyright (c) Arends, JBAM Johan
رقم الانضمام: edsbas.A8E56CE5
قاعدة البيانات: BASE