Ictal hypoventilation contributes to cardiac arrhythmia and SUDEP: report on two deaths in video-EEG-monitored patients.
Sudden unexplained death in epilepsy (SUDEP) is a common cause of death in patients with epilepsy, with cardiorespiratory dysfunction and a primary cessation of cerebral function proposed as causes. We report two cases of SUDEP in patients with intractable temporal lobe epilepsy undergoing video-EEG (electroencephalography) telemetry at two centers. Both had secondarily generalized convulsions. EEG, electrocardiography (ECG), and respiratory changes in these two patients are reported herein. Ictal/postictal hypoventilation may contribute to SUDEP with the resulting hypoxemia and acidosis leading to failure of recovery of cortical function and eventual cardiac failure.
Department of Neurology, University of California, Davis, Sacramento, CA, USA.
Lisa M
LM
Bateman
Mark
M
Spitz
Masud
M
Seyal
D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology; D002423:Cause of Death; D003645:Death, Sudden / Q000209:etiology*; D004562:Electrocardiography; D004569:Electroencephalography / Q000706:statistics & numerical data*; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006935:Hypercapnia; D007040:Hypoventilation / Q000150:complications* / Q000453:epidemiology; D000860:Hypoxia; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D013686:Telemetry; D014741:Video Recording; D014743:Videotape Recording