Casciato Sara, Quarato Pier Paolo, Mascia Addolorata, D'Aniello Alfredo, Esposito Vincenzo, Morace Roberta, Pavone Luigi, Di Bonaventura Carlo, Tombini Mario, Assenza Giovanni, Di Gennaro Giancarlo
IRCCS NEUROMED, 86077 Pozzilli (IS), Italy.
Department of Human Neurosciences, Sapienza University, 00185 Rome, Italy.
Brain Sci. 2020 Jul 12;10(7):443. doi: 10.3390/brainsci10070443.
Ictal asystole (IA) is a rare event observed in people with epilepsy (PwE). Clinical and IA video-electroencephalographic findings may be helpful in screening for high-risk subjects. From all PwE undergoing video-EEG for presurgical evaluation between 2000 and 2019, we retrospectively selected those with at least one IA (R-R interval of ≥3 s during a seizure). IA was detected in eight out of 1088 (0.73%) subjects (mean age: 30 years; mean epilepsy duration: 9.6 years). Four out of them had a history of atonic falls. No patients had cardiac risk factors or cardiovascular diseases. Seizure onset was temporal ( = 5), temporo-parietal ( = 1) or frontal ( = 2), left-sided and right-sided in five and two patients, respectively. In one case a bilateral temporal independent seizure onset was recorded. IA was recorded in 11 out of 18 seizures. Mean IA duration was 13 s while mean IA latency from seizure onset was 26.7 s. Symptoms related to IA were observed in all seizures. IA is a rare and self-limiting event often observed during video-EG in patients with a history of atonic loss of consciousness and/or tardive falls in the course of a typical seizure.
发作期心脏停搏（IA）是在癫痫患者（PwE）中观察到的罕见事件。临床和IA的视频脑电图结果可能有助于筛查高危受试者。在2000年至2019年期间接受视频脑电图术前评估的所有PwE中，我们回顾性地选择了至少有一次IA发作（发作期间R-R间期≥3秒）的患者。1088名受试者中有8名（0.73%）检测到IA（平均年龄：30岁；平均癫痫病程：9.6年）。其中4人有失张力跌倒史。所有患者均无心脏危险因素或心血管疾病。发作起始部位为颞叶（=5例）、颞顶叶（=1例）或额叶（=2例），左侧发作5例，右侧发作2例。1例记录到双侧颞叶独立发作起始。18次发作中有11次记录到IA。IA平均持续时间为13秒，而IA距发作起始的平均潜伏期为26.7秒。所有发作中均观察到与IA相关的症状。IA是一种罕见的自限性事件，在有失张力性意识丧失和/或典型发作过程中迟发性跌倒病史的患者进行视频脑电图检查时经常观察到。
