Ictal ECG changes in temporal lobe epilepsy

Arquivos de neuro-psiquiatria
L M LiJ W Sander

Abstract

Changes in cardiac rhythm may occur during epileptic seizures and this has been suggested as a possible mechanism for sudden unexpected death amongst patients with chronic epilepsy (SUDEP). We have studied ECG changes during 61 complex partial seizures of temporal lobe origin in 20 patients. Tachycardia was observed in 24/61 (39%) and bradycardia in 3/61 (5%). The mean and median tachycardia rate was 139 and 140 beats/min (range 120-180). The longest R-R interval observed was 9 seconds. No difference was found in regard to the lateralisation of seizures and cardiac arrhytmia. One of the patients with bradycardia was fitted with a demand cardiac pacemaker, which appeared to decrease the number of his falls. In conclusion, ictal cardiac changes which may be seen in temporal lobe epilepsy (TLE) are sinus tachycardia and occasionally sinus bradycardia. Patients presenting vague complains suggestive of either TLE or cardiac dysrhythmia, simultaneous monitoring with EEG/ECG is required, and if the episodes are frequent, video-EEG should be considered. Further studies on this subject are warranted as this may shed some light on possible mechanisms for SUDEP.

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Citations

Apr 7, 2004·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Giancarlo Di GennaroGiampaolo Cantore
Nov 10, 2001·Seizure : the Journal of the British Epilepsy Association·M GarciaA Rabinowicz
Apr 5, 2014·Seizure : the Journal of the British Epilepsy Association·Katherine S EgglestonRobert S Fisher
Jul 8, 2000·Epilepsia·D M Ficker
Dec 6, 2001·Journal of Neurosurgical Anesthesiology·K SatoT Yoshimoto
Oct 6, 2000·Arquivos de neuro-psiquiatria·C L JorgeE M Yacubian
Jun 26, 2003·Archives of Pathology & Laboratory Medicine·James B Weitzman

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