癫痫发作期间的呼吸暂停和心动过缓：与癫痫猝死的关系。
Apnoea and bradycardia during epileptic seizures: relation to sudden death in epilepsy.
作者信息
Nashef L, Walker F, Allen P, Sander J W, Shorvon S D, Fish D R
机构信息
Telemetry Unit, National Hospital for Neurology and Neurosurgery, London, UK.
出版信息
J Neurol Neurosurg Psychiatry. 1996 Mar;60(3):297-300. doi: 10.1136/jnnp.60.3.297.
Abstract
OBJECTIVE
To record non-invasively ictal cardiorespiratory variables.
METHODS
Techniques employed in polysomnography were used in patients with epilepsy undergoing EEG-video recording at a telemetry unit.
RESULTS
Apnoea (> 10, range > 10-63, mean 24 s) was seen in 20 of 47 clinical seizures (three secondary generalised, 16 complex partial, and one tonic) and 10 of 17 patients. Apnoea was central in 10 patients, but obstructive apnoea was also recorded in three of 10. Oxyhaemoglobin saturation (SpO2) dropped to less than 85% in 10 seizures (six patients). An increase in heart rate was common (91% of seizures). Bradycardia/sinus arrest was documented in four patients (mean maximum RR interval 5.36, range 2.8-8.6 s) but always in the context of a change in respiratory pattern.
CONCLUSION
Ictal apnoea was often seen. The occurrence of bradycardia in association with apnoea suggests the involvement of cardiorespiratory reflexes. Similar mechanisms may operate in cases of sudden death in epilepsy.
摘要
目的
无创记录发作期心肺变量。
方法
在遥测病房对癫痫患者进行脑电图-视频记录时，采用多导睡眠图技术。
结果
47次临床发作中的20次（3次继发性全身性发作、16次复杂部分性发作和1次强直发作）以及17例患者中的10例出现呼吸暂停（>10秒，范围>10 - 63秒，平均24秒）。10例患者的呼吸暂停为中枢性，但10例中的3例也记录到阻塞性呼吸暂停。10次发作（6例患者）中氧合血红蛋白饱和度（SpO2）降至85%以下。心率增加很常见（91%的发作）。4例患者记录到心动过缓/窦性停搏（平均最大RR间期5.36秒，范围2.8 - 8.6秒），但均与呼吸模式改变有关。
结论
常可见发作期呼吸暂停。心动过缓与呼吸暂停同时出现提示心肺反射参与其中。类似机制可能在癫痫猝死病例中起作用。
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