Slater Jeremy D, Benbadis Selim, Verrier Richard L
Stratus, Inc., Irving TX, USA.
Department of Epilepsy/Neurology, University of South Florida, Tampa General Hospital, Tampa, FL, USA.
Epilepsy Behav Rep. 2024 Oct 30;28:100726. doi: 10.1016/j.ebr.2024.100726. eCollection 2024.
Concurrent electrocardiogram (ECG) and electroencephalogram (EEG) recording both ictally and interictally has significant value in the comprehensive management of epilepsy. This review highlights the diagnostic utility of simultaneous ECG and EEG monitoring in differentiating between epileptic and cardiac events, detecting cardiac abnormalities, and identifying autonomic dysfunction. The critical role of this combined approach to defining the mechanisms underlying cardiac morbidity and sudden cardiac death in patients with epilepsy and in guiding therapeutic interventions is underscored. The "Epileptic Heart Syndrome" is examined, illustrating how chronic epilepsy can adversely affect cardiac structure and function, leading to increased risk for interictal cardiac arrhythmias, morbidities, and mortality. The findings emphasize the need for standardized protocols for routine concurrent ECG and EEG recording in epilepsy monitoring units both ictally and interictally to ensure comprehensive patient care, improve diagnostic accuracy, and potentially reduce epilepsy-related morbidity and mortality. Future research directions are proposed to address existing gaps and to advance the technology and methodology for concurrent monitoring including wearable and computer-based monitoring systems.
发作期和发作间期同步记录心电图（ECG）和脑电图（EEG）在癫痫的综合管理中具有重要价值。本综述强调了同步ECG和EEG监测在鉴别癫痫事件和心脏事件、检测心脏异常以及识别自主神经功能障碍方面的诊断效用。强调了这种联合方法在确定癫痫患者心脏发病机制和心源性猝死以及指导治疗干预方面的关键作用。对“癫痫性心脏综合征”进行了研究，阐述了慢性癫痫如何对心脏结构和功能产生不利影响，导致发作间期心律失常、发病率和死亡率增加。研究结果强调，癫痫监测单元需要制定标准化方案，以便在发作期和发作间期常规同步记录ECG和EEG，以确保全面的患者护理，提高诊断准确性，并可能降低癫痫相关的发病率和死亡率。提出了未来的研究方向，以填补现有空白，并推进同步监测的技术和方法，包括可穿戴和基于计算机的监测系统。
