Department of Medicine for the Elderly, Queen Elizabeth University Hospital Campus, Glasgow, UK
Department of Medicine for the Elderly, Queen Elizabeth University Hospital Campus, Glasgow, UK.
BMJ Case Rep. 2021 Jul 20;14(7):e240268. doi: 10.1136/bcr-2020-240268.
Ictal bradycardia and asystole are rare, but potentially serious complications of epileptic seizures. We present a case series of three such patients diagnosed through our syncope service. For two patients, treatment with anticonvulsant therapy alone achieved symptom control. The third patient was initially managed with permanent pacemaker insertion due to detection of a significant ventricular pause. He subsequently developed more pronounced symptoms suggestive of seizure.Ictal asystole can cause significant diagnostic challenge and management strategies remain controversial due to the overlap in presentation to cardiology and neurology services. The number of patients affected is low, impeding the formulation of an evidence base for treatment. We propose multidisciplinary working facilitated by a specialist syncope service as a means of recognising and treating this condition more effectively.
癫痫发作时的心动过缓和心搏停止是罕见但潜在严重的并发症。我们通过晕厥服务诊断了三例此类患者。对于两名患者，单独使用抗癫痫药物治疗即可控制症状。第三名患者最初因检测到明显的心室停搏而接受了永久性起搏器植入。随后，他出现了更明显的癫痫发作症状。心搏停止可能会导致重大的诊断挑战，由于心血管病和神经病学服务之间的表现存在重叠，管理策略仍存在争议。受影响的患者人数较少，这阻碍了制定治疗证据基础。我们建议通过专门的晕厥服务促进多学科合作，以更有效地识别和治疗这种病症。
