Kendirli Mustafa Tansel, Aparci Mustafa, Kendirli Nurten, Tekeli Hakan, Karaoglan Mustafa, Senol Mehmet Guney, Togrol Erdem
Neurology Department, GATA Haydarpasa Training Hospital, Istanbul, Turkey
Cardiology Department, Etimesgut Military Hospital, Ankara, Turkey.
Clin EEG Neurosci. 2015 Jul;46(3):214-7. doi: 10.1177/1550059414551554. Epub 2014 Sep 23.
Arrhythmia is not uncommon in the etiology of syncope which mimics epilepsy. Data about the epilepsy induced vagal tonus abnormalities have being increasingly reported. So we aimed to evaluate what a neurologist may gain by a simultaneous electrocardiogram (ECG) and electroencephalogram (EEG) recording in the patients who underwent EEG testing due to prediagnosis of epilepsy. We retrospectively evaluated and detected ECG abnormalities in 68 (18%) of 376 patients who underwent EEG testing. A minimum of 20 of minutes artifact-free recording were required for each patient. Standard 1-channel ECG was simultaneously recorded in conjunction with the EEG. In all, 28% of females and 14% of males had ECG abnormalities. Females (mean age 49 years, range 18-88 years) were older compared with the male group (mean age 28 years, range 16-83 years). Atrial fibrillation was more frequent in female group whereas bradycardia and respiratory sinus arrhythmia was higher in male group. One case had been detected a critical asystole indicating sick sinus syndrome in the female group and treated with a pacemaker implantation in the following period. Simultaneous ECG recording in conjunction with EEG testing is a clinical prerequisite to detect and to clarify the coexisting ECG and EEG abnormalities and their clinical relevance. Potentially rare lethal causes of syncope that mimic seizure or those that could cause resistance to antiepileptic therapy could effectively be distinguished by detecting ECG abnormalities coinciding with the signs and abnormalities during EEG recording.
心律失常在晕厥病因中并不少见,而晕厥可类似癫痫发作。关于癫痫诱发的迷走神经张力异常的数据报道日益增多。因此,我们旨在评估对于因癫痫预诊断而接受脑电图(EEG)检查的患者,同步进行心电图(ECG)和脑电图记录,神经科医生能从中获得什么。我们回顾性评估并检测了376例接受EEG检查患者中的68例(18%)的心电图异常。每位患者至少需要20分钟无伪差记录。标准单通道心电图与脑电图同时记录。总体而言,28%的女性和14%的男性存在心电图异常。女性组(平均年龄49岁,范围18 - 88岁)比男性组(平均年龄28岁,范围16 - 83岁)年龄更大。房颤在女性组中更常见,而心动过缓和呼吸性窦性心律失常在男性组中更高。在女性组中检测到1例提示病态窦房结综合征的严重心搏停止,并在随后植入起搏器进行治疗。同步进行心电图记录与脑电图检查是检测和明确并存的心电图和脑电图异常及其临床相关性的临床前提条件。通过检测与脑电图记录期间的体征和异常同时出现的心电图异常,可有效区分可能罕见的类似癫痫发作的晕厥致死原因或那些可能导致对抗癫痫治疗产生抵抗的原因。