Syncope vs. Seizure: Ictal Bradycardia and Ictal Asystole.

IF 0.9 Q4 CLINICAL NEUROLOGY Case Reports in Neurological Medicine Pub Date : 2024-05-06 eCollection Date: 2024-01-01 DOI:10.1155/2024/1299282
Sumika Ouchida, Kaitlyn Parratt, Armin Nikpour, Greg Fairbrother
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Abstract

Background: Ictal arrhythmia is a rare condition that causes arrhythmic manifestations induced by epileptic seizures, including asystole or bradycardia. Ictal asystole (IA) is a very rare condition found in patients undergoing video-encephalography (EEG) monitoring. It is often related to temporal lobe epilepsy and can cause syncope, which can lead to injury or even death. Case Presentation. Two patients with epilepsy showed symptoms of syncope. Both patients underwent 4-day ambulatory EEG tests and were diagnosed with IA. Following the tests, the patients were implanted with a permanent pacemaker, and one of them underwent a temporal lobectomy. As a result of these procedures, the patients experienced a reduction in episodes of symptomatic syncope.

Conclusion: Patients with ictal asystole and symptomatic ictal bradycardia are at increased risk of falls due to seizures. Although there are no specific guidelines for managing this condition, antiseizure medications, epilepsy surgery, and cardiac pacemaker implantation have been effective treatments.

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晕厥与癫痫发作:心动过缓和心动过速。
背景:异位性心律失常是一种罕见的疾病,由癫痫发作诱发心律失常表现,包括间歇或心动过缓。在接受视频脑电图(EEG)监测的患者中,极位性心律失常(IA)是一种非常罕见的病症。它通常与颞叶癫痫有关,可引起晕厥,导致受伤甚至死亡。病例介绍。两名癫痫患者出现晕厥症状。两名患者均接受了为期 4 天的动态脑电图检测,并被诊断为癫痫综合征。检查后,患者被植入了永久起搏器,其中一人还接受了颞叶切除术。通过这些治疗,患者症状性晕厥的发作次数有所减少:结论:发作性心搏骤停和症状性发作性心动过缓患者因癫痫发作而跌倒的风险增加。虽然目前还没有管理这种情况的具体指南,但抗癫痫药物、癫痫手术和心脏起搏器植入术都是有效的治疗方法。
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审稿时长
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