Circulatory and Respiratory Changes in Spontaneous Epileptic Seizures in Man

Magnæs, B.; Nornes, Helge

doi:10.1159/000114609

Cited by 32 publications

(22 citation statements)

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“…[15][16][17][18]20,21 It may be difficult to prevent either of these groups from having a first seizure. 23 Either can increase neurologic morbidity and mortality. In the latter group, the duration of AED prophylaxis might be unduly long to prevent the small number of observed seizures, prolonging patient exposure to possible adverse effects and costs of pharmacotherapy.…”

Section: Resultsmentioning

confidence: 99%

Anticonvulsant prophylaxis and timing of seizures after aneurysmal subarachnoid hemorrhage

et al. 2000

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In this SAH population, the majority of seizures happened before medical presentation. In-hospital seizures were rare and occurred more than 7 days postictus for patients receiving AED prophylaxis. The vast majority of putative clinical predictors did not help predict the occurrence of seizures; only the thickness of the cisternal clot was of value in predicting seizures. Patient selection for and the efficacy and timing of AED prophylaxis after SAH deserve prospective evaluation.

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Section: Resultsmentioning

confidence: 99%

Anticonvulsant prophylaxis and timing of seizures after aneurysmal subarachnoid hemorrhage

et al. 2000

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“…Subarachnoid and Vessel wall damage occurring in acute hypertensive states is thought to be due to loss of autoregulatory capacity and "breakthrough" or over-stretching of vessel walls at mean arterial pressures (MAP) of over 140 mmHg.`3 -15 Worsening of vessel damage with recurrent seizures may therefore in part be explained by the fact that MAP rises considerably during each seizure. 16 Animal studies have demonstrated blood brain barrier breakdown with extravasation of Evans Blue, a protein bound tracer, when "breakthrough" of MABP occurs.14 Clinicopathological study of neurological complications due to hypertensive disorders ofpregnancy The histological studies did not provide any evidence to suggest that vascular changes were localised to any specific regions of the brain. However, Govan'0 commented that petechial haemorrhages appeared predominantly in the occipital lobes in eclamptic patients.…”

Section: Resultsmentioning

confidence: 99%

Clinicopathological study of neurological complications due to hypertensive disorders of pregnancy.

Richards

Graham

Bullock

1988

Journal of Neurology, Neurosurgery & Psychiatry

122

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SUMMARY Forty-three women with neurological complications secondary to eclampsia or severe pre-eclampsia were studied by CT scanning and in six intracranial pressure (ICP) monitoring was carried out. In seven women who died, neuropathological findings were correlated with clinical features. Cerebral oedema was present in 27 of the patients studied and the severity of oedema correlated to the duration of intermittent seizures. In five of the six women who had ICP measured, this was found to be transiently high. Intracranial haemorrhage was demonstrated in four of the 43 women, all of whom died. Hypoxic-ischaemic cerebral damage and fibrinoid necrosis were the most important neuropathological lesions identified. The management of neurological complications of eclampsia may be placed upon a more rational basis by an understanding of the mechanisms responsible for these lesions.Neurological complications due to hypertensive disorders of pregnancy are the most common cause of maternal death from these disorders. -3 However, the pathogenesis of these complications, namely eclamptic seizures, coma, visual disturbances and localising neurological defects, remains poorly understood. The purpose of this report is to document the neuropathological findings of seven women dying from eclampsia or severe pre-eclampsia. These changes are related to clinical and CT observations in a larger series of 43 women with pregnancy-induced hypertension (PIH) and one or more of the above mentioned neurological complications. The pathophysiological mechanisms which may have led to these lesions are reviewed.

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“…In BCS, systemic BP appears to display at least two different patterns. The first pattern is characterized by a simultaneous increase of systemic BP and HR during the seizure (4, 18, 19). The second pattern consists of a biphasic behavior of BP with an initial increase followed by a drop (4, 19).…”

Section: Discussionmentioning

confidence: 99%

“…The first pattern is characterized by a simultaneous increase of systemic BP and HR during the seizure (4, 18, 19). The second pattern consists of a biphasic behavior of BP with an initial increase followed by a drop (4, 19). The HR is commonly accelerated during BCS (4, 20).…”

Section: Discussionmentioning

confidence: 99%

Impaired Baroreflex Sensitivity after Bilateral Convulsive Seizures in Patients with Focal Epilepsy

2017

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BackgroundSudden unexpected death in epilepsy (SUDEP) is probably due to an autonomic failure in the early postictal phase after bilateral convulsive seizures (BCS) in the majority of cases. The baroreflex sensitivity (BRS) is an established and reliable biomarker of autonomic function and sudden cardiac death.ObjectiveTo investigate whether postictal BRS depends on seizure type.MethodsBeat-to-beat systemic blood pressure and heart rate were continuously and non-invasively recorded with the ccNexfin® device in patients with focal epilepsy undergoing video-EEG monitoring. BRS was calculated using the sequence as well as the spectral method. A random mixed linear model was applied to analyze the influence of seizure type on BRS during three different time periods of 15-min length each (interictal, preictal, and postictal). In addition, the possible effects of other factors (hypertension, hemispheric lateralization of ictal activity, epilepsy type, body position, vigilance state) were explored. Data are given as median with interquartile range.ResultsA total of 26 seizures of 26 patients were analyzed. In BCS (n = 7), BRS significantly dropped from a preictal value of 15.0 ms/mm Hg (13.0–19.4) and an interictal value of 15.6 ms/mm Hg (12.0–20.4) to 3.1 ms/mm Hg (2.7–10.5) during the postictal period (p < 0.0001) according to the sequence method. This finding was replicated with the spectral method. In contrast, focal seizures (n = 19) did not lead to significant alterations of BRS in the postictal phase.ConclusionPostictal BRS depends on the seizure type and is markedly impaired after BCS. The present study provides further evidence for a disturbed autonomic function following BCS. These findings might be related to cardiovascular failure in the context of SUDEP.

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Circulatory and Respiratory Changes in Spontaneous Epileptic Seizures in Man

Cited by 32 publications

References 0 publications

Anticonvulsant prophylaxis and timing of seizures after aneurysmal subarachnoid hemorrhage

Anticonvulsant prophylaxis and timing of seizures after aneurysmal subarachnoid hemorrhage

Clinicopathological study of neurological complications due to hypertensive disorders of pregnancy.

Impaired Baroreflex Sensitivity after Bilateral Convulsive Seizures in Patients with Focal Epilepsy

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