Postictal immobility and generalized EEG suppression are associated with the severity of respiratory dysfunction

Epilepsia
Jonathan KuoMasud Seyal

Abstract

The pathophysiology of sudden unexpected death in epilepsy (SUDEP) remains undetermined. Seizures are accompanied by respiratory dysfunction (RD). Postictal generalized electroencephalography (EEG) suppression (PGES) may follow generalized tonic-clonic seizures (GTCS). Following GTCS patients have impaired arousal and may be motionless. Patients with SUDEP are usually prone. Postictal immobility (PI) may contribute to SUDEP by not permitting repositioning of the head to allow unimpeded ventilation. To determine whether RD and/or ictal characteristics are associated with PI, we analyzed patients with GTCS in the epilepsy monitoring unit. We investigated for associations between PI duration and PGES, ictal/postictal oxygen saturation (SpO2 ), end-tidal CO2 (ETCO2 ), seizure localization, duration, and tonic and total convulsive phase duration. We investigated for linkage between PGES and these measures. Seventy patients with 181 GTCS and available SpO2 and/or ETCO2 data were studied. Simple linear regression analysis by seizures showed that PI duration was associated with peak periictal ETCO2 (p = 0.03), duration of oxygen desaturation (p = 0.005) and with SpO2 nadir (p = 0.02). PI duration was not associated with tonic, convulsi...Continue Reading

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Citations

Aug 30, 2016·Lancet Neurology·Orrin DevinskyGeorge Richerson
Aug 29, 2018·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·Y TangD Zhou
Dec 21, 2018·Neurology·Sylvain RheimsUNKNOWN REPO2MSE study group
Jan 7, 2018·Neurology·Gregory L Krauss, Philippe Ryvlin
Apr 10, 2020·Expert Review of Neurotherapeutics·Max Christian PenselRainer Surges
Jun 11, 2020·Epilepsia·Sándor BeniczkyPhilippe Ryvlin
May 28, 2020·Epilepsia·Elisa BrunoUNKNOWN RADAR-CNS Consortium
Nov 20, 2016·Epilepsia·Daniel M GoldenholzWilliam H Theodore
Nov 21, 2018·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·Niravkumar Barot, Maromi Nei
Jun 14, 2019·Epilepsy Currents·David King-Stephens
Jun 12, 2020·Epilepsia Open·Charles Ákos SzabóSreekanth Koneru
May 26, 2018·Current Neurology and Neuroscience Reports·Xiuhe Zhao, Samden D Lhatoo
Aug 5, 2017·Frontiers in Neurology·Richard D BagnallChristopher Semsarian
Jan 9, 2019·Frontiers in Neurology·Benton S PurnellGordon F Buchanan
Dec 24, 2019·Experimental Neurology·Alexandra N PetrucciGordon F Buchanan
Nov 3, 2020·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·L Brian HickmanBen Julian A Palanca
May 29, 2021·Frontiers in Neurology·Xiuhe ZhaoNuria Lacuey
Jun 11, 2021·Journal of Neuroscience Research·Enes AkyüzMohd Farooq Shaikh
Aug 4, 2021·Autonomic Neuroscience : Basic & Clinical·Maromi Nei, Allyson Pickard
Aug 25, 2018·Seizure : the Journal of the British Epilepsy Association·Marjan AsadollahiKurosh Gharagozli

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