Newey Christopher R, Sarwal Aarti
Department of Neurology, University of Chicago Medical Center, Chicago, IL, USA.
Department of Anesthesiology (Section on Critical Care Medicine), Wake Forest School of Medicine, Winston-Salem, NC, USA ; Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Neurohospitalist. 2015 Oct;5(4):NP3-6. doi: 10.1177/1941874415569070.
Ictal bradyarrhythmias are rare episodes occurring in patients with or without a past cardiac history. These episodes go unnoticed unless the patient is monitored on simultaneous video-electroencephalogram and 1-lead electrocardiogram. Recognizing ictal bradyarrhythmias is important, since episodes may predispose patients to sudden, unexplained death in epilepsy. We present 2 cases of ictal asystole in patients with right temporal lobe epilepsy. The first patient had seizures refractory to medical therapy and received a pacemaker. The seizures in the second patient responded well to antiepileptic medication, and a pacemaker was deferred. These cases highlight the differing cardiovascular treatment options for ictal asystole.
发作期缓慢性心律失常是一种罕见的发作情况，可发生于有或无既往心脏病史的患者。除非患者同时接受视频脑电图和单导联心电图监测，否则这些发作情况往往会被忽视。认识到发作期缓慢性心律失常很重要，因为这些发作可能使癫痫患者易发生不明原因的猝死。我们报告2例右侧颞叶癫痫患者出现发作期心搏停止的病例。首例患者药物治疗难治性癫痫发作，接受了起搏器治疗。第二例患者的癫痫发作对抗癫痫药物反应良好，暂未植入起搏器。这些病例凸显了发作期心搏停止的不同心血管治疗选择。
