title: Cardiac arrest associated with epileptic seizures: A case report with simultaneous EEG and ECG.
abstract: Ictal asystole is a rare, probably underestimated manifestation of epileptic seizures whose pathophysiology is still debated. This report describes two patients who had cardiac asystole at the end of their seizure. The first patient was a 13-year-old boy with complex partial seizures.. His MRI showed symmetrical signal abnormality in the bilateral parietooccipital lobe accompanied by mild gliosis and volume loss. During a 3-day long-term video-EEG monitoring, he had cardiac arrest at the end of one of his seizures that was secondarily generalized. The second one was a 42-year-old veteran with penetrating head trauma in the left frontal lobe due to shell injury. During long-term video-EEG monitoring, he had one generalized tonic-clonic seizure accompanied by bradycardia and cardiac asystole. Asystoles could have a role in the incidence of sudden unexpected death in epilepsy (SUDEP), meaning that the presence of ictal bradycardia is a risk factor for SUDEP. In cases of epileptic cardiac dysrhythmia, prolonged simultaneous EEG/ECG monitoring may be required. Cardiological investigation should be included in epilepsy management.
authors: Shefa Neuroscience Research Center, Khatamolanbia Hospital, Tehran, Iran ; Isfahan Neurosciences Research Center, Isfahan, Iran.
authors: Jafar
authors: J
authors: Mehvari
authors: Shefa Neuroscience Research Center, Khatamolanbia Hospital, Tehran, Iran ; Pars Advanced Medical Research Center, Pars Hospital, Tehran, Iran.
authors: Fatemeh
authors: F
authors: Fadaie
authors: Tehran University of Medical Sciences, Tehran, Iran.
authors: Shirin
authors: S
authors: Omidi
authors: Shefa Neuroscience Research Center, Khatamolanbia Hospital, Tehran, Iran.
authors: Mohammadmehran
authors: M
authors: Poorsina
authors: Shefa Neuroscience Research Center, Khatamolanbia Hospital, Tehran, Iran.
authors: Masoumeh
authors: M
authors: Najafi Ziarani
authors: Shefa Neuroscience Research Center, Khatamolanbia Hospital, Tehran, Iran ; Pars Advanced Medical Research Center, Pars Hospital, Tehran, Iran.
authors: Marzieh
authors: M
authors: Gharekhani
authors: Shefa Neuroscience Research Center, Khatamolanbia Hospital, Tehran, Iran ; Shahid Beheshti University of Medical Science, Tehran, Iran.
authors: Nahid
authors: N
authors: Beladimoghadam
authors: Shefa Neuroscience Research Center, Khatamolanbia Hospital, Tehran, Iran.
authors: Elham
authors: E
authors: Rahimian
authors: Isfahan Neurosciences Research Center, Isfahan, Iran.
authors: Houshang
authors: H
authors: Moein
authors: Isfahan Neurosciences Research Center, Isfahan, Iran.
authors: Majid
authors: M
authors: Barakatain
authors: Isfahan Neurosciences Research Center, Isfahan, Iran.
authors: Mohammad
authors: M
authors: Basiratnia
authors: Shefa Neuroscience Research Center, Khatamolanbia Hospital, Tehran, Iran ; Pars Advanced Medical Research Center, Pars Hospital, Tehran, Iran.
authors: Seyed Sohrab
authors: SS
authors: Hashemi Fesharaki
keywords: Cardiac arrest; Ictal asystole; SUDEP; Seizure