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Open AccessArticle

Ictal Asystole in Drug-Resistant Focal Epilepsy: Two Decades of Experience from an Epilepsy Monitoring Unit

1
IRCCS NEUROMED, 86077 Pozzilli (IS), Italy
2
Department of Human Neurosciences, Sapienza University, 00185 Rome, Italy
3
Epilepsy Unit, Department of Human Neurosciences, Policlinico “Umberto I”, “Sapienza” University, 00185 Rome, Italy
4
Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico, 00185 Rome, Italy
*
Author to whom correspondence should be addressed.
Brain Sci. 2020, 10(7), 443; https://doi.org/10.3390/brainsci10070443
Received: 17 June 2020 / Revised: 30 June 2020 / Accepted: 8 July 2020 / Published: 12 July 2020
(This article belongs to the Special Issue Advances in Epilepsy)
Background: Ictal asystole (IA) is a rare event observed in people with epilepsy (PwE). Clinical and IA video-electroencephalographic findings may be helpful in screening for high-risk subjects. Methods: From all PwE undergoing video-EEG for presurgical evaluation between 2000 and 2019, we retrospectively selected those with at least one IA (R–R interval of ≥3 s during a seizure). Results: IA was detected in eight out of 1088 (0.73%) subjects (mean age: 30 years; mean epilepsy duration: 9.6 years). Four out of them had a history of atonic falls. No patients had cardiac risk factors or cardiovascular diseases. Seizure onset was temporal (n = 5), temporo-parietal (n = 1) or frontal (n = 2), left-sided and right-sided in five and two patients, respectively. In one case a bilateral temporal independent seizure onset was recorded. IA was recorded in 11 out of 18 seizures. Mean IA duration was 13 s while mean IA latency from seizure onset was 26.7 s. Symptoms related to IA were observed in all seizures. Conclusion: IA is a rare and self-limiting event often observed during video-EG in patients with a history of atonic loss of consciousness and/or tardive falls in the course of a typical seizure. View Full-Text
Keywords: video-EEG monitoring; ictal asystole; temporal lobe epilepsy; cardiac pacemaker; syncope video-EEG monitoring; ictal asystole; temporal lobe epilepsy; cardiac pacemaker; syncope
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Casciato, S.; Quarato, P.P.; Mascia, A.; D’Aniello, A.; Esposito, V.; Morace, R.; Pavone, L.; Di Bonaventura, C.; Tombini, M.; Assenza, G.; Di Gennaro, G. Ictal Asystole in Drug-Resistant Focal Epilepsy: Two Decades of Experience from an Epilepsy Monitoring Unit. Brain Sci. 2020, 10, 443.

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