28. Arrhythmias and seizures: A broad spectrum of interactions. Issue 12 (December 2016)

• Record Type: Journal Article
• Authors: Pasini, E.; Riguzzi, P.; Volpi, L.; Michelucci, R.
• Is Part Of: Clinical neurophysiology. Volume 127:Issue 12(2016:Dec.)
• Page Start: e329
• Publication Date: 2016-12
• Subjects: Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2016.10.040
• Languages: English
• ISSNs: 1388-2457

Abstract

Abstract : Historically, cardiologist and neurologist have been required in the diagnosis of loss of consciousness. Convulsive syncopes related to vaso-vagal asystole are counted in differential diagnosis of epileptic seizures because of the several clinical similarities. Moreover, during epileptic seizures, heart is often involved showing many patterns of alteration ranging from brief tachycardia to prolonged ictal asystole. Sometimes these episodes imply also respiratory changes suggesting a probable vegetative alteration during or immediately after the seizure. Prolonged video-EEG monitoring allowed us to record many of these phenomena. Despite the frequent long-life benign history, our practical approach was frequently aggressive and the patient underwent to pace-maker implant, at least in case of prolonged ictal asystole. In fact, during the last years, the ghost of SUDEP (Sudden Unexspected Death in Epilepsy) has modified our overtures on this field. Notwithstanding, reviewing our cases, we found different type of possible ictal arrhythmias according with familial and personal history of the patient, cardiological evaluation, drug response, patient's social life and patient's expectations. We suggest that all these variables might be considered when evaluating these cases because of a possible tailored therapeutical approach.