Agostini Susan D, Aniles Ejerzain, Sirven Joseph, Drazkowski Joseph F
Banner Good Samaritan Medical Center, Epilepsy Monitoring Unit, Phoenix, Arizona, USA.
Neurodiagn J. 2012 Sep;52(3):250-60.
Ictal asystole may be a potent marker for epilepsy patients at high risk for sudden unexpected death in epilepsy (SUDEP). The use of inpatient long-term video-electroencephalographic (VEEG) monitoring coupled with simultaneous continuous cardiac telemetry is an important tool to detect ictal asystole as well as other significant ictal cardiac arrhythmias. In this paper a case of ictal asystole detected during VEEG is presented. Routine 12-lead EKG was normal upon admission. After antiepileptic medication was tapered, the patient had a typical complex partial seizure with oral automatisms at onset followed by secondary generalization. Ictal onset was noted in left temporal lobe with subsequent spread to the right temporal region. A 20 second period of asystole began just prior to the secondary generalization. During this admission the patient underwent a potentially life-saving pacemaker implantation. The use of cardiac telemetry and baseline EKG are suggested for patients admitted into epilepsy monitoring units as part of the standard epilepsy monitoring protocol.
发作期心脏停搏可能是癫痫患者发生癫痫性猝死（SUDEP）高危风险的一个有力标志。采用住院患者长期视频脑电图（VEEG）监测并同时进行连续心脏遥测，是检测发作期心脏停搏以及其他显著的发作期心律失常的一项重要工具。本文介绍了1例在VEEG监测期间检测到发作期心脏停搏的病例。入院时常规12导联心电图正常。在抗癫痫药物逐渐减量后，患者开始出现典型的复杂部分性发作，起始有口部自动症，随后继发全面性发作。发作起始于左侧颞叶，随后扩散至右侧颞叶区域。在继发全面性发作之前开始出现一段20秒的心脏停搏期。在此次住院期间，患者接受了可能挽救生命的起搏器植入术。建议将心脏遥测和基线心电图作为癫痫监测单元收治患者标准癫痫监测方案的一部分。
