Pasini Elena, Michelucci Roberto
IRCCS Istituto delle Scienze Neurologiche di Bologna, Unit of Neurology, Bellaria Hospital, 40139 Bologna, Italy.
J Clin Med. 2023 Sep 6;12(18):5805. doi: 10.3390/jcm12185805.
The heart and seizures are closely linked by an indissoluble relationship that finds its basis in the cerebral limbic circuit whose mechanisms remain largely obscure. The differential diagnosis between seizures and syncopes has always been a cornerstone of the collaboration between cardiologists and neurologists and is renewed as a field of great interest for multidisciplinary collaboration in the era of the diffusion of prolonged telemonitoring units. The occurrence of ictal or post-ictal arrhythmias is currently a cause of great scientific debate with respect to the role and risks that these complications can generate (including sudden unexpected death in epilepsy). Furthermore, the study of epileptic seizures and the arrhythmological complications they cause (during and after seizures) also allows us to unravel the mechanisms that link them. Finally, intercritical arrhythmias may represent great potential in terms of the prevention of cardiological risk in epileptic patients as well as in the possible prediction of the seizures themselves. In this paper, we review the pertaining literature on this subject and propose a scheme of classification of the cases of arrhythmia temporally connected to seizures.
心脏与癫痫发作通过一种不可分割的关系紧密相连，这种关系基于大脑边缘系统回路，但其机制在很大程度上仍不清楚。癫痫发作与晕厥的鉴别诊断一直是心脏病专家和神经科医生合作的基石，在长期远程监测设备普及的时代，它作为多学科合作的一个极具吸引力的领域再次受到关注。发作期或发作后心律失常的发生目前在这些并发症可能产生的作用和风险（包括癫痫猝死）方面引发了激烈的科学争论。此外，对癫痫发作及其引发的心律失常并发症（发作期间和发作后）的研究也有助于我们揭示将它们联系起来的机制。最后，发作间期心律失常在预防癫痫患者的心脏风险以及可能预测癫痫发作本身方面可能具有巨大潜力。在本文中，我们回顾了关于该主题的相关文献，并提出了与癫痫发作在时间上相关的心律失常病例的分类方案。
