Krankenanstalt Rudolfstiftung Wien, Juchgasse 25, 1030 Vienna, Austria.
Wittgenstein Centre, Vienna Institute of Demography, Austrian Academy of Sciences, Welthandelsplatz 2, Level 2, 1020 Vienna, Austria.
J Neurol Sci. 2019 Feb 15;397:42-47. doi: 10.1016/j.jns.2018.12.005. Epub 2018 Dec 5.
Takotsubo syndrome(TTS) is often preceded by emotional or physical stress. Epileptic seizures are described in >100 cases. It is unknown whether patients with immediate and delayed detection of seizure-induced TTS differ. We screened the literature and compared clinical and electrocardiographic (ECG) findings. In 48 cases with seizure-associated TTS, the time between seizure and TTS-detection was reported. Troponin levels were elevated in 37/40. ECG abnormalities were negative T-waves(40%), ST-elevations(33%) and ventricular fibrillation/flutter(10%). Immediate detection was reported in 23 patients, in the remaining 25 patients, TTS was detected 5-288 h postictally. Patients did not differ in gender, age or symptoms. Negative T-waves were more frequent in patients with delayed detection(64 vs. 13%, p = .0009), whereas ECG-abnormalities suggesting acute myocardial infarction tended to be more prevalent in patients with immediate detection. Due to lack of typical symptoms, seizure-induced TTS can be overlooked. Postictally, an ECG should be recorded and troponin levels measured. New T-wave inversions might indicate seizure-induced TTS.
心尖球囊样综合征（TTS）常发生于情绪或躯体应激之后。有>100 例癫痫发作患者的描述。目前尚不清楚即刻和延迟发现癫痫诱发的 TTS 是否存在差异。我们对文献进行了筛选，并比较了临床和心电图（ECG）表现。在 48 例与癫痫相关的 TTS 患者中，报告了癫痫发作与 TTS 发现之间的时间间隔。37/40 例患者的肌钙蛋白水平升高。心电图异常为负 T 波（40%）、ST 段抬高（33%）和室颤/扑动（10%）。23 例患者为即刻发现，在其余 25 例患者中，TTS 在癫痫发作后 5-288 小时被发现。患者在性别、年龄或症状方面无差异。延迟发现的患者中更常见负 T 波（64% vs. 13%，p = .0009），而提示急性心肌梗死的 ECG 异常在即刻发现的患者中更常见。由于缺乏典型症状，癫痫诱发的 TTS 可能被忽视。癫痫发作后，应记录心电图并测量肌钙蛋白水平。新的 T 波倒置可能提示癫痫诱发的 TTS。
