Honig Asaf, Chen Shmuel, Benninger Felix, Bar-Yossef Rima, Eichel Roni, Kipervasser Svetlana, Blatt Ilan, Neufeld Miri Y, Ekstein Dana
Department of Neurology, the Agnes Ginges Center of Neurogenetics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Department of Cardiology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
BMC Neurol. 2015 May 14;15:80. doi: 10.1186/s12883-015-0336-y.
Early identification of cardiac asystole as a reason for syncope is of uttermost significance, as insertion of a cardiac pacemaker can save the patient's life and prevent severe injury. The aim of this work was to emphasize the subtle and unusual presentations of asystole in patients evaluated in epilepsy units.
We reviewed the clinical presentation, ECG and EEG data of a series of seven patients who were evaluated in four epilepsy units and were diagnosed with asystole.
Three patients had unusual clinical manifestations of cardiac asystole, resembling epileptic seizures. Three patients had asystole induced by epileptic seizures and in one patient the diagnosis was not clear. All patients except one were implanted with a pacemaker and improved clinically.
Seizure-induced asystole is a rare complication of epilepsy and asystole may clinically mimic epileptic seizures. A high level of suspicion and thorough prolonged cardiac and EEG monitoring are mandatory for reaching the right diagnosis. As the diagnosis is rare and difficult to reach, a flow chart to assist diagnosis is suggested.
早期识别心脏停搏作为晕厥的原因至关重要，因为植入心脏起搏器可挽救患者生命并防止严重损伤。这项工作的目的是强调在癫痫单元接受评估的患者中，心脏停搏的细微和不寻常表现。
我们回顾了在四个癫痫单元接受评估并被诊断为心脏停搏的一系列七名患者的临床表现、心电图和脑电图数据。
三名患者有心脏停搏的不寻常临床表现，类似于癫痫发作。三名患者因癫痫发作诱发心脏停搏，一名患者的诊断不明确。除一名患者外，所有患者均植入了起搏器，临床症状有所改善。
癫痫发作诱发的心脏停搏是癫痫的一种罕见并发症，心脏停搏在临床上可能模仿癫痫发作。高度怀疑并进行全面、长时间的心脏和脑电图监测对于做出正确诊断是必不可少的。由于这种诊断罕见且难以做出，建议使用一个辅助诊断的流程图。
