P5677Ictal asystole and bradycardia patients with epilepsy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R A Teryan ◽  
S E Serdyuk ◽  
K V Davtyan ◽  
O M Drapkina
Keyword(s):  
Partial Seizure ◽  
Partial Seizures ◽  
Loop Recorder ◽  
Cardiac Pacemakers ◽  
Generalized Seizures ◽  
Life Threatening ◽  
Epilepsy Localization ◽  
Temporal Localization ◽  
Patients With Epilepsy ◽  
Special Patient

Abstract Background Events of ictal bradycardia or asystole may be of importance in epilepsy patients showing with ictal falls and are a funder to SUDEP. With using implantable loop recorders, we can detect ictal bradycardia or asystole. And implantation of cardiac pacemakers may prevent life-threatening syncope, cardiac arrest, and disturbances. Purpose The purpose of this study is to look at how many ictal bradycardia or asystole and match with localization, types of seizure and antiepileptic drugs in a patient with hard to treat epilepsy. Methods Patients with hard to treat epilepsy were implanted loop recorders. Patients or their relations were activated loop recorder (with a special patient assistant) during or after seizure depending on the type of seizure. Results 204 patients included in the study. The mean duration of loop recording 24 months. 1168 ECG seizure were reordered of 204 patients, 494 (42%) secondary generalized seizures and 674 (58%) partial seizures. Nine patients (4%) were recorded ictal bradycardia and ictal asystole. Only four patients with ictal asystole and bradycardia take AED (antiepileptic drug) inhibit sodium channels. During seizure were recorded only 14 (1, 1%) seizure with ictal asystole and bradycardia of nine patients, 6 (42%) – with ictal asystole (5 – SA-block, 1 – AV-block), 8 (57%) – ictal bradycardia. Ten (71%) events of 14 was secondary generalized seizures, 4 (28%) - partial seizures. Five ictal asystoles recorded during secondarily generalized seizures, and only 1 partial seizure. Five ictal bradycardias reordered during secondarily generalized seizures, 3 - partial seizure. Frontal-temporal localization only 4 patients, 1 – occipital-frontal, 1 – frontal, 3 – without consistent epilepsy localization. Three patients with bilateral lateralization, 2 – left lateralization, 1 – right lateralization, 3 – without consistent epilepsy lateralization. Conclusions Ictal asystole can be problematic to diagnose because of both its under-recognition and its appearance only during seizures. In this study, we showed the most life-threatening events occurred in patients with the secondarily generalized seizures. Bradyarrhythmias can one of possible sudden unexplained death in epilepsy patients (SUDEP). No clear association was seen between ictal bradycardia/asystole and lateralization or localization of seizure onset.

scholarly journals Epilepsy from Cerebral Arteriovenous Malformations

1983 ◽  
Vol 10 (2) ◽  
pp. 91-95 ◽  
Author(s):  
Richard Leblanc ◽  
William Feindel ◽  
Roméo Ethier
Keyword(s):  
Parietal Lobe ◽  
Epileptiform Activity ◽  
Contrast Material ◽  
Occipital Lobe ◽  
Ct Scanning ◽  
Mass Effect ◽  
Partial Seizures ◽  
Generalized Seizures ◽  
Vascular Enhancement ◽  
Patients With Epilepsy

SUMMARY:Twenty-seven patients with epilepsy as the only manifestation of a cerebral AVM were seen at the MNI/MNH from 1973 to 1981. The nine females and eighteen males between the ages of fourteen and fifty-four years (Mean 25.2 years) had epilepsy for an average of 3.5 years prior to the diagnosis of AVM.Seven patients had primarily generalized seizures, ten patients had partial seizures with complex symptoms, fourteen patients had partial seizures with elementary symptoms, and thirteen patients had secondarily generalized seizures. Although there was no history of intracranial hemorrhage, seven patients had negative hemispheric signs (hemiatrophy, hemianopia, dysphasia, hemiparesis), two had impaired mentation, and two were ataxic. The EEG, normal in ten cases, showed non-epileptiform activity in six cases, and focal epileptiform activity in eleven cases. Angiographic and/or histological examination revealed eight small (less than 2 cm in diameter) and nineteen large lesions. Fifteen AVMs involved the frontal lobe, ten the temporal lobe, five the parietal lobe, and one the occipital lobe. Angiography failed to demonstrate three frontal and three temporal AVMs.Plain CT scanning demonstrated a high or low density lesion without a mass effect in sixteen cases, enlargement of the ipsilateral ventricle or Sylvian fissure in seven cases, and diffuse ventricular enlargement in three cases. CT scanning was performed after the intravenous injection of contrast material in nineteen cases and demonstrated vascular enhancement in fifteen cases and an abnormal blood vessel in six cases. Two angiographically occult AVMs demonstrated vascular enhancement with infusion CT scanning, thereby demonstrating the vascular nature of the lesion where angiography had failed to do so.

scholarly journals Differential Aspects of Sleep Epilepsy

1985 ◽  
Vol 12 (4) ◽  
pp. 317-320 ◽  
Author(s):  
G. Bryan Young ◽  
Warren T. Blume ◽  
George A. Wells ◽  
Wilson C. Mertens ◽  
Suzanne Eder
Keyword(s):  
Epileptiform Activity ◽  
Effective Control ◽  
Partial Seizures ◽  
Drug Management ◽  
Family Histories ◽  
Generalized Seizures ◽  
Anti Epileptic Drug ◽  
Patients With Epilepsy

ABSTRACT:A review of patients with epilepsy showed that 5.9% had seizures exclusively in sleep (ES) and 4.7% had seizures predominantly but not exclusively in sleep (PS). These groups were compared with a group (W) with seizures mainly in wakefulness. The following significant differences were obtained: 1) generalized convulsions predominated in the ES while partial seizures were more common among PS and W patients, 2) seizures occurred less frequently in the ES group, and 3) more W patients had EEGs with generalized epileptiform activity and positive family histories for epilepsy.We suggest the lower frequency of seizures in the ES group and the declining prevalence of sleep epilepsy are due to: 1) the high proportion of generalized as opposed to partial seizures in sleep and 2) more effective control of generalized seizures compared to partial seizures by modern anti-epileptic drug management.

scholarly journals Duration of epilepsy and severity of the disease in neurosurgical patients

2018 ◽  
Vol 10 (3) ◽  
pp. 44-51
Author(s):  
G. V. Odintsova ◽  
M. V. Aleksandrov ◽  
A. Yu. Ulitin ◽  
A. V. Koloteva
Keyword(s):  
Surgical Treatment ◽  
Optimal Time ◽  
Surgical Interventions ◽  
Generalized Seizures ◽  
Long Duration ◽  
Neurosurgical Patients ◽  
Eeg Changes ◽  
Severity Of The Disease ◽  
Temporal Localization ◽  
Patients With Epilepsy

The problem of a late referral to surgical treatment in epilepsy was addressed in this study.Objective: To elucidate whether the course of epilepsy is influenced by the duration of the disease.Materials and Methods. A cohort of 91 patients with epilepsy who underwent surgical interventions from 2012 to 2017, were retrospectively studied. The disease dynamics (frequency and type of seizures) as well as the EEG changes were assessed.Results. Of those patients, 77% had epilepsy more than 10 years, and 41% – more than 20 years. The temporal localization was found in 71% of cases, and the extra-temporal – in 29%. In all patients, seizures occurred at least once a month. Secondary generalized seizures were found in 58% of patients, and status epilepticus was observed in 30% of cases.Conclusion. The course of epilepsy in the clinical and neurophysiological terms deteriorates with a long duration of the disease. The present results can be used to determine the optimal time for a referral for surgical treatment.

Anticonvulsant Therapy in Children: An Update

1996 ◽  
Vol 9 (1) ◽  
pp. 27-41
Author(s):  
Judith L. Scala ◽  
Cathy Y. Poon
Keyword(s):  
Adverse Effects ◽  
The United States ◽  
New Drugs ◽  
Adjunctive Treatment ◽  
Partial Seizures ◽  
Intractable Seizures ◽  
Generalized Seizures ◽  
Life Threatening ◽  
Pediatric Use ◽  
New Generation

Over the years, extensive research has led to the development of a new generation of anticonvulsant medications for the treatment of patients with intractable seizure disorders. Currently three new drugs have been approved in the United States since 1993, and many others have entered into the later stages of development. The purpose of this article is to discuss the pharmacology, pharmacokinetics, drug interactions, clinical use, adverse effects, and dosage and administration of felbamate, gabapentin, lamotrigine, and vigabatrin. Felbamate is indicated in children as adjunctive therapy in the treatment of partial and generalized seizures secondary to Lennox-Gastaut syndrome. Because of life-threatening adverse effects, including aplastic anemia and hepatotoxicity, felbamate is reserved for use only when the benefits of treatment outweigh the risks of toxicity. Presently, gabapentin is indicated as adjunctive treatment of partial seizures with or without generalization in patients older than 12 years of age. To date gabapentin has not been studied in patients younger than age 12 years. Even though lamotrigine is not approved by the Food and Drug Administration (FDA) for pediatric use, preliminary clinical trials show promising results in the treatment of partial and absence seizures as well as Lennox-Gastaut syndrome. Many studies have evaluated the use of vigabatrin for the treatment of intractable seizures. Seizure types most effectively treated include partial seizures, Lennox-Gastaut syndrome, and possibly infantile spasms. Lamotrigine and vigabatrin should be used with caution in patients with myoclonic seizures because an increase in seizure frequency may occur. Copyright © 1996 by W.B. Saunders Company

Epilepsy in Nicolaides–Baraitser Syndrome: Review of Literature and Report of 25 Patients Focusing on Treatment Aspects

2021 ◽  
Author(s):  
Benedikt Hofmeister ◽  
Celina von Stülpnagel ◽  
Cornelia Betzler ◽  
Francesca Mari ◽  
Alessandra Renieri ◽  
...  
Keyword(s):  
Neurodevelopmental Outcome ◽  
Initial Response ◽  
Clinical Findings ◽  
Generalized Seizures ◽  
Parent Support Group ◽  
Anticonvulsive Drugs ◽  
Epilepsy Classification ◽  
Structural Epilepsy ◽  
Patients With Epilepsy ◽  
Electroencephalogram Eeg

AbstractNicolaides–Baraitser syndrome (NCBRS), caused by a mutation in the SMARCA2 gene, which goes along with intellectual disability, congenital malformations, especially of face and limbs, and often difficult-to-treat epilepsy, is surveyed focusing on epilepsy and its treatment. Patients were recruited via “Network Therapy of Rare Epilepsies (NETRE)” and an international NCBRS parent support group. Inclusion criterion is NCBRS-defining SMARCA2 mutation. Clinical findings including epilepsy classification, anticonvulsive treatment, electroencephalogram (EEG) findings, and neurodevelopmental outcome were collected with an electronic questionnaire. Inclusion of 25 NCBRS patients with epilepsy in 23 of 25. Overall, 85% of the participants (17/20) reported generalized seizures, the semiology varied widely. EEG showed generalized epileptogenic abnormalities in 53% (9/17), cranial magnetic resonance imaging (cMRI) was mainly inconspicuous. The five most frequently used anticonvulsive drugs were valproic acid (VPA [12/20]), levetiracetam (LEV [12/20]), phenobarbital (PB [8/20]), topiramate (TPM [5/20]), and carbamazepine (CBZ [5/20]). LEV (9/12), PB (6/8), TPM (4/5), and VPA (9/12) reduced the seizures' frequency in more than 50%. Temporary freedom of seizures (>6 months) was reached with LEV (4/12), PB (3/8), TPM (1/5, only combined with PB and nitrazepam [NZP]), and VPA (4/12). Seizures aggravation was observed under lamotrigine (LTG [2/4]), LEV (1/12), PB (1/8), and VPA (1/12). Ketogenic diet (KD) and vagal nerve stimulation (VNS) reduced seizures' frequency in one of two each. This first worldwide retrospective analysis of anticonvulsive therapy in NCBRS helps to treat epilepsy in NCBRS that mostly shows only initial response to anticonvulsive therapy, especially with LEV and VPA, but very rarely shows complete freedom of seizures in this, rather genetic than structural epilepsy.

scholarly journals Etiology of epilepsy a prospective study of 210 cases

1991 ◽  
Vol 49 (3) ◽  
pp. 251-254 ◽  
Author(s):  
Walter Oleschko Arruda
Keyword(s):  
Ct Scan ◽  
Neurological Examination ◽  
Epileptic Seizures ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Blood Tests ◽  
Generalized Seizures ◽  
A Prospective Study ◽  
Csf Examination

The objective of this study was to establish the etiology of epilepsy in 210 chronic epileptics (110 female, 100 male), aged 14-82 years (34.2±13.3). Patients less than 10 years-old and alcoholism were excluded. All underwent neurological examination, routine blood tests, EEG and CT-scan. Twenty patients (10.5%) were submitted to spinal tap for CSF examination. Neurological examination was abnormal in 26 (12.4%), the EEG in 68 (45.5%), and CT-scan in 93 (44.3%). According to the International Classification of Epileptic Seizures (1981), 101 (48.1%) have generalized seizures, 66 (31.4%) partial seizures secondarily generalized, 25 (11.8%) simple partial and complex partial seizures, and 14 (6.6%) generalized and partial seizures. Four patients (2.0%) could not be classified. In 125 (59.5%) patients the etiology was unknown. Neurocysticercosis accounted for 57 (27.1%) of cases, followed by cerebrovascular disease 8 (3.8%), perinatal damage 5 (2.4%), familial epilepsy 4 (1.9%), head injury 4 (1.9%), infective 1 (0.5%), and miscelanea 6 (2.8%).

Cyclic Vomiting and Recurrent Abdominal Pains as Migraine or Epileptic Equivalents*

Cephalalgia ◽  
1983 ◽  
Vol 3 (2) ◽  
pp. 115-118 ◽  
Author(s):  
G. Lanzi ◽  
U. Balottin ◽  
A. Ottolini ◽  
F. Rosano Burgio ◽  
E. Fazzi ◽  
...  
Keyword(s):  
The Other ◽  
Periodic Syndrome ◽  
Age Group ◽  
Pediatric Age ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Pediatric Age Group ◽  
Generalized Seizures ◽  
Epileptic Disorder ◽  
Cyclic Vomiting

A retrospective method was used to estimate the incidence of recurring motion-sickness, cyclic vomiting and abdominal pain considered as different manifestations of a so-called periodic syndrome in 100 migraine sufferers, 100 epileptics and 100 control subjects in the pediatric age group. Such recurrent symptoms are significantly more frequent in those suffering from migraine than in the other two groups. Examination of subgroups of patients affected by particular forms of migraine (classical and common) and of epilepsy (generalized seizures, simple partial seizures, complex partial seizures) contributed little new to our understanding of the nature of periodic syndrome. It is concluded that the above symptoms of periodic syndrome should generally be considered as manifestations of a migrainous rather than of an epileptic disorder.

Epileptic Seizure-Induced Hypoxemia in Infants with Apparent Life-Threatening Events

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 148-156
Author(s):  
John Hewertson ◽  
Martin P. Samuels ◽  
David P. Southall ◽  
Christian F. Poets ◽  
Stewart G. Boyd ◽  
...  
Keyword(s):  
Median Duration ◽  
Epileptic Seizure ◽  
Sinus Tachycardia ◽  
Partial Seizures ◽  
Severe Hypoxemia ◽  
Life Threatening ◽  
Electrocardiogram Ecg ◽  
Electroencephalogram Eeg ◽  
Normal Standard ◽  
Median Interval

Objective. To describe the physiologic changes that occur during epileptic seizure (ES)-induced apparent life-threatening events (ALTE) and to provide an explanation for the mechanism whereby the hypoxemia characterizing these events occurred. Patients and design. Six infants were retrospectively selected from a group of 17 because they had ALTE documented on physiologic recordings where the first change in signals was in the electroencephalogram (EEG). The 17 infants had clinical features suggestive of partial seizures (but normal standard EEGs) and were from a sample of 172 infants with recurrent ALTE. All 17 infants underwent continuous recordings of breathing, electrocardiogram (ECG), oxygenation, and EEG, but only in 6 was an ES-induced ALTE recorded and the physiologic changes described. Results. Twenty-three ALTE were documented in six infants. Events commenced with an abnormality in the EEG, followed by a decrease in SaO2 after a median interval of 27 seconds (range 2 to 147). Despite resuscitation, the median duration of severe hypoxemia (SaO2 ≤60%) was 40 seconds (range 8 to 74). In 18 events (five infants) there was a median of four apneic pauses (range 1 to 9) preceding the decrease in SaO2 by a median duration of 24 seconds (range 3 to 48). The longest apneic pause per event lasted a median of 19 seconds (range 8 to 47). Breathing movements continued in five events (four infants), and expiratory airflow in one. Sinus tachycardia was found in 19 of the 23 events (six infants), but there were no cardiac arrhythmias. Conclusions. ES in infants can manifest as ALTE and be accompanied by potentially life-threatening episodes of severe hypoxemia and apnea, despite a normal EEG between events.

scholarly journals Brain Mechanisms of Altered Consciousness in Focal Seizures

2011 ◽  
Vol 24 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Andrew P. Bagshaw ◽  
Andrea E. Cavanna
Keyword(s):  
Brain Function ◽  
Fundamental Issue ◽  
Partial Seizures ◽  
Altered Consciousness ◽  
Main Criterion ◽  
Central Concept ◽  
Complex Partial Seizures ◽  
Focal Seizures ◽  
Generalized Seizures ◽  
The Brain

Consciousness is a central concept in epileptology, relevant to the understanding of both focal and generalized seizures. Within focal seizures, impairment of consciousness has long been considered as the main criterion differentiating complex partial seizures (CPS) from simple partial seizures With the development of improved tools for investigating human brain function, new insights into the brain mechanisms of altered consciousness in CPS have become available. This paper reviews the existing literature on how the currently available methods can be used to address the fundamental issue of how CPS alter consciousness.

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