title: Oxygen desaturations triggered by partial seizures: implications for cardiopulmonary instability in epilepsy.
abstract: OBJECTIVE
  The occurrence of hypoxemia in adults with partial seizures has not been systematically explored. Our aim was to study in detail the temporal dynamics of this specific type of ictal-associated hypoxemia.
  
  
  METHODS
  During long-term video/EEG monitoring (LTM), patients underwent monitoring of oxygen saturation using a digital Spo2 (pulse oximeter) transducer. Six patients (nine seizures) were identified with oxygen desaturations after the onset of partial seizure activity.
  
  
  RESULTS
  Complex partial seizures originated from both left and right temporal lobes. Mean seizure duration (+/-SD) was 73 +/- 18 s. Mean Spo2 desaturation duration was 76 +/- 19 s. The onset of oxygen desaturation followed seizure onset with a mean delay of 43 +/- 16 s. Mean (+/-SD) Spo2 nadir was 83 +/- 5% (range, 77-91%), occurring an average of 35 +/- 12 s after the onset of the desaturation. One seizure was associated with prolonged and recurrent Spo2 desaturations.
  
  
  CONCLUSIONS
  Partial seizures may be associated with prominent oxygen desaturations. The comparable duration of each seizure and its subsequent desaturation suggests a close mechanistic (possibly causal) relation. Spo2 monitoring provides an added means for seizure detection that may increase LTM yield. These observations also raise the possibility that ictal ventilatory dysfunction could play a role in certain cases of sudden unexpected death in epilepsy in adults with partial seizures.
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA. ablum@caregroup.harvard.edu
authors.forename: A S
authors.initials: AS
authors.lastname: Blum
authors.forename: J R
authors.initials: JR
authors.lastname: Ives
authors.forename: A L
authors.initials: AL
authors.lastname: Goldberger
authors.forename: I C
authors.initials: IC
authors.lastname: Al-Aweel
authors.forename: K B
authors.initials: KB
authors.lastname: Krishnamurthy
authors.forename: F W
authors.initials: FW
authors.lastname: Drislane
authors.forename: D L
authors.initials: DL
authors.lastname: Schomer
mesh_terms: D000328:Adult; D000818:Animals; D001342:Autonomic Nervous System Diseases / Q000209:etiology / Q000503:physiopathology; D006224:Cricetinae; D003645:Death, Sudden / Q000209:etiology; D004562:Electrocardiography; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000097:blood / Q000378:metabolism* / Q000503:physiopathology; D004833:Epilepsy, Temporal Lobe / Q000097:blood / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000097:blood* / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010092:Oximetry; D010100:Oxygen / Q000097:blood* / Q000378:metabolism; D012120:Respiration Disorders / Q000209:etiology / Q000503:physiopathology
chemical_list: D010100:Oxygen