Ictal Asystole in Temporal Lobe Epilepsy: A Possible Cause of Sudden Unexplained Death - A Case Report

Al-Awwad, Ahmad; Katyal, Roohi; Herren, Cherie L

doi:10.1080/21646821.2018.1531671

Cited by 2 publications

(1 citation statement)

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“…IAinduced syncope may confuse the clinical picture or delay a diagnosis of epilepsy [6]. There are reports that link the occurrence of IB and IA with an increased risk of sudden unexpected death in epilepsy (SUDEP) [7,8]. Finally, IB and IA are a demonstration of a clinically challenging electrical interaction between the brain and heart [9,10].…”

Section: Introductionmentioning

confidence: 99%

Heart versus brain: a case of ictal asystole in temporal lobe epilepsy

Yassin

Aldabbour

Bagić

et al. 2020

Egypt J Neurol Psychiatry Neurosurg

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Background: Ictal asystole is a rare phenomenon. Most reported cases are in persons with long-standing focal epilepsy originating from the temporal lobe. Its occurrence may complicate the clinical presentation or delay diagnosis, and it is thought to be associated with increased risk of sudden unexpected death in epilepsy. Case presentation: We report the case of a 55-year-old female person with epilepsy who suffered ictal asystole for 10 s while under monitoring at the Epilepsy Monitoring Unit. We then review briefly the pathophysiology and current management modalities for this phenomenon. Discussion: The first step in management of this condition is usually the optimization of anti-seizure drugs. In our case, a 2-year fall-free period was achieved with optimization of medical treatment. Pacemaker implantation can also be attempted to prevent ictal asystole-related falls and injury, while refractory cases may benefit from epilepsy surgery in terms of both seizure control and prevention of ictal asystole.

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