期刊
EPILEPSIA
卷 55, 期 7, 页码 E67-E71出版社
WILEY-BLACKWELL
DOI: 10.1111/epi.12614
关键词
Heart rate variability; Short QT; Sudden unexpected death in epilepsy; Video-EEG
资金
- Danish Council for Independent Research
- Lundbeck Foundation
- Health science Aarhus University
- Aase & Ejner Danielsens Fond
- Brodrene Hartmann Foundation
- Lundbeck Foundation [R83-2011-7684] Funding Source: researchfish
Evidence for seizure-induced cardiac dysrhythmia leading to sudden unexpected death in epilepsy (SUDEP) has been elusive. We present a patient with focal cortical dysplasia who has had epilepsy for 19 years and was undergoing presurgical evaluation. The patient did not have any cardiologic antecedents. During long-term video-electroencephalography (EEG) monitoring, following a cluster of secondarily generalized tonicclonic seizures (GTCS), the patient had prolonged postictal generalized EEG suppression, asystole, followed by arrhythmia, and the patient died despite cardiopulmonary resuscitation. Analysis of heart rate variability showed a marked increase in the parasympathetic activity during the period preceding the fatal seizures, compared with values measured 1 day and 7 months before, and also higher than the preictal values in a group of 10 patients with GTCS without SUDEP. The duration of the QTc interval was short (335-358 msec). This unfortunate case documented during video-EEG monitoring indicates that autonomic imbalance and seizure-induced cardiac dysrhythmias contribute to the pathomechanisms leading to SUDEP in patients at risk (short QT interval).
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