Department of Epileptology, University of Bonn Medical Center, Sigmund-Freud-Str. 25, 53105 Bonn, Germany.
Seizure. 2012 Oct;21(8):643-5. doi: 10.1016/j.seizure.2012.05.012. Epub 2012 Jun 12.
We describe two male patients with focal epilepsy in whom transitory episodes of atrial fibrillation (AF) lasting for up to 25h were detected in the context of generalized tonic-clonic seizures (GTCSs). In five of seven previously published cases of transitory AF associated with epileptic seizures, AF was also associated with GTCS, suggesting a pathophysiological link via GTCS-related increase in sympathetic tone and release of catecholamines. Importantly, AF increases the risk of thromboembolic cerebral ischemia, prompting the question of whether antithrombotic preventive treatment should be initiated in people with pharmacoresistant epilepsy and prolonged peri-ictal AF. Furthermore, AF can considerably impair cardiac output and may, via this mechanism, contribute to the risk of sudden unexpected death in epilepsy following GTCS.
我们描述了两名患有局灶性癫痫的男性患者，在全身性强直-阵挛性发作（GTCS）期间检测到长达 25 小时的阵发性心房颤动（AF）。在之前发表的七例与癫痫发作相关的短暂性 AF 中，有五例也与 GTCS 相关，这表明通过与 GTCS 相关的交感神经张力增加和儿茶酚胺释放存在病理生理学联系。重要的是，AF 增加了血栓栓塞性脑缺血的风险，这引发了一个问题，即对于药物难治性癫痫和发作间期延长的 AF 患者，是否应该开始进行抗血栓预防治疗。此外，AF 可显著降低心输出量，并且可能通过这种机制导致 GTCS 后癫痫患者发生突发性意外死亡的风险增加。
