Qadri Haseeb Mehmood, Ismail Fiza, Khawaja Momina, Sohail Amna, Bukhari Seeneen, Bashir Asif
Dr. Haseeb Mehmood Qadri, Punjab Institute of Neurosciences, Lahore, Punjab, Pakistan.
Dr. Fiza Ismail Continental Medical College, Lahore, Punjab, Pakistan.
Pak J Med Sci. 2024 Dec;40(12PINS Suppl):S114-S125. doi: 10.12669/pjms.40.12(PINS).11274.
BACKGROUND & OBJECTIVE: Takotsubo cardiomyopathy (TCM), manifests as left ventricular dysfunction triggered by physical or emotional stress. It leads to higher morbidity in epileptic patients and can progress to complications. To find out the correlation between Takotsubo cardiomyopathy and epilepsy and to investigate pathophysiology and associated types of epilepsy.
This systematic review adhered to PRISMA guidelines and was sourced from the PubMed Central database. Search terms were pertinent to cardiomyopathy and epilepsy. Sixteen studies, comprising case reports and a case series were selected from 2000 to 2023 for data extraction. The quality evaluation was executed via the Joanna Briggs Institute Critical Appraisal checklist.
The review included 18 female patients with a mean age of 57.22 years. Predominant symptoms included tonic-clonic seizures (66.66%). Seizure-induced TCM pathophysiology implicates catecholamine surge, precipitating myocardial stunting and characteristic apical ballooning. Most patients had a history of epilepsy (38.88%). ECG findings showed tachycardia (38.88%) and ST-segment elevation (38.88%). Elevated troponin levels were noted in 83.33% of patients. Echocardiography showed reduced ejection fraction (72.22%), hypokinesia (38.88%) and akinesis (27.77%). Treatment involved Benzodiazepines (50%), Beta-blockers (61.11%) and Phenytoin (38.88%). The majority of patients showed improvement in echocardiography findings (55.55%) and ECG findings (11.11%).
TCM in epilepsy patients evinces significant female predominance, with pathophysiology rooted in seizure-induced catecholamine surge. Early recognition in high-risk patients is essential in preventing complications.
应激性心肌病（TCM）表现为因身体或情绪应激引发的左心室功能障碍。它在癫痫患者中导致更高的发病率，并可进展为并发症。旨在找出应激性心肌病与癫痫之间的关联，并研究其病理生理学及相关癫痫类型。
本系统评价遵循PRISMA指南，数据来源于PubMed Central数据库。检索词与心肌病和癫痫相关。从2000年至2023年选取了16项研究，包括病例报告和病例系列进行数据提取。通过乔安娜·布里格斯研究所批判性评价清单进行质量评估。
该评价纳入了18例女性患者，平均年龄57.22岁。主要症状包括强直阵挛发作（66.66%）。癫痫诱发的应激性心肌病病理生理学涉及儿茶酚胺激增，导致心肌发育迟缓及特征性心尖气球样变。大多数患者有癫痫病史（38.88%）。心电图表现为心动过速（38.88%）和ST段抬高（38.88%）。83.33%的患者肌钙蛋白水平升高。超声心动图显示射血分数降低（72.22%）、运动减弱（38.88%）和运动消失（27.77%）。治疗包括使用苯二氮䓬类药物（50%）、β受体阻滞剂（61.11%）和苯妥英（38.88%）。大多数患者的超声心动图表现（55.55%）和心电图表现（11.11%）有所改善。
癫痫患者中的应激性心肌病明显以女性为主，其病理生理学根源在于癫痫诱发的儿茶酚胺激增。对高危患者进行早期识别对于预防并发症至关重要。
