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.
Bateman
Lisa M
LM
Department of Neurology, University of California, Davis, Sacramento, CA, USA.
Spitz
Mark
M
Seyal
Masud
M
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