Epilepsy Centre, University Hospital Freiburg, Breisacher Str. 64, 79106 Freiburg im Breisgau, Germany.
Seizure. 2011 Mar;20(2):167-72. doi: 10.1016/j.seizure.2010.11.017. Epub 2010 Dec 22.
Ictal-related cardiac asystole is supposed to be a risk factor for sudden unexpected death in epilepsy (SUDEP). We retrospectively analyzed the occurrence of ictal asystole in 2003 epilepsy patients undergoing long-term video EEG/ECG monitoring from 1/1999 to 6/2010 at the Freiburg epilepsy centre. Seven patients had cardiac arrest with a duration of at least 3s; 6 ictal, one postictal. In all patients, the temporal lobe was involved in ictal activity based on neurophysiological investigations or morphological lesion. Whereas asystole was self-limited in six cases, one patient with insular seizure origin had to undergo cardiopulmonary resuscitation. Interestingly, also patients with a short history of epilepsy, low seizure frequency and under treatment in monotherapy showed episodes of asystole. In all cases, even with brief cardiac arrest, asystole was associated with subsequent EEG flattening. In conclusion, ictal asystole is a rare event even in a population undergoing major changes in antiepileptic medication. Temporal lobe epilepsy was associated with a risk for asystole; cardiac arrest also occurred in patients who, based on their history, might have not been considered at elevated risk for SUDEP.
癫痫发作相关的心搏骤停被认为是癫痫猝死（SUDEP）的一个危险因素。我们回顾性分析了 1999 年 1 月至 2010 年 6 月在弗莱堡癫痫中心接受长期视频脑电图/心电图监测的 2003 例癫痫患者中发作性心搏骤停的发生情况。7 例患者出现持续至少 3s 的心脏骤停；6 例为发作期，1 例为发作后期。所有患者的神经生理学检查或形态学病变均提示发作期活动涉及颞叶。尽管 6 例心搏骤停自行终止，但起源于岛叶的 1 例患者需要心肺复苏。有趣的是，即使在癫痫病史较短、癫痫发作频率较低且接受单药治疗的患者中，也会出现心搏骤停发作。在所有情况下，即使心脏骤停时间短暂，心搏骤停也与随后的脑电图平坦化相关。总之，即使在抗癫痫药物发生重大变化的人群中，发作性心搏骤停也是一种罕见事件。颞叶癫痫与心搏骤停的风险相关；即使根据病史，可能认为患者不会处于 SUDEP 的高危状态，也会发生心脏骤停。
