Abstract
Ictal bradycardia, which is considered to be one of the causes of sudden unexplained death in epilepsy, is rare. A 10-year-old girl with focal cortical dysplasia in her right centroparietal region developed transient ictal bradycardia during cluster seizures. Brain magnetic resonance imaging demonstrated a high signal intensity lesion adjacent to the focal cortical dysplasia lesion. Ictal (99m)Tc-ethyl cysteinate dimer single-photon emission computed tomography (SPECT) detected hyperperfusion in an area containing the high signal intensity lesion, which was located close to the insular cortex. Since the hyperperfusion zone observed on SPECT was considered to reflect seizure propagation, it is possible that the ictal bradycardia experienced in the present case was caused by the following mechanism: The repetitive seizure activity caused the high-intensity lesion seen on MRI to expand into the right insular cortex, which controls cardiac rhythm, resulting in ictal bradycardia.
References
Sep 1, 1992·Neurology·S M OppenheimerV C Hachinski
Nov 12, 1990·Brain Research·S M Oppenheimer, D F Cechetto
Jul 2, 1999·Stroke; a Journal of Cerebral Circulation·S L TokgözogluA Oto
Jul 17, 2003·European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society·M SeeckE Roulet
Nov 25, 2004·Epilepsy Currents·Orrin Devinsky
May 3, 2006·Epilepsia·Jeffrey W BrittonGregory D Cascino
Jan 14, 2010·Epilepsia·Brian D MoseleyElaine Wirrell
Jan 14, 2010·Epilepsia·Cristian Sevcencu, Johannes J Struijk
May 13, 2011·Epilepsy Research·Brian D MoseleyJeffrey Britton
May 17, 2011·Forensic Science, Medicine, and Pathology·Christopher M Milroy
Nov 11, 2011·The New England Journal of Medicine·Orrin Devinsky
Oct 31, 2012·CNS Drugs·Dale C Hesdorffer, Torbjorn Tomson
Jan 9, 2013·Epilepsia·Pavel KrsekMichael Duchowny
Jun 5, 2013·Epilepsia·Kanwaljit SinghSanjeev V Kothare
Oct 22, 2013·Epilepsy & Behavior : E&B·Milena PavlovaSanjeev V Kothare