caa a22 4500 463158148 CHVBK 20180406164740.0 cr unu---uuuuu 170326e20070601xx s 000 0 eng 10.1007/s10286-007-0429-9 doi (NATIONALLICENCE)springer-10.1007/s10286-007-0429-9 Clinical cues for detecting ictal asystole [Elektronische Daten] [Gena Ghearing, Thomas Munger, Allan Jaffe, Eduardo Benarroch, Jeffrey Britton] Objective: The occurrence of asystole during an epileptic seizure is the most dramatic manifestation of ictal bradycardia. Recognition of ictal asystole is important as treatment with both antiepileptic drugs and cardiac pacing may be necessary. The purpose of this study was to identify clinical cues to aid in the detection of ictal asystole. Methods: We analyzed the clinical and electrophysiologic features of all recorded seizures in consecutive patients diagnosed with ictal bradycardia and asystole on prolonged video-EEG/ECG monitoring over a 14year period. Results: Twenty-nine seizures with ictal bradycardia were identified in 13 patients. Of these, 11 seizures in seven patients were associated with asystole. Bilateral transient limb movements consisting of asymmetric posturing or jerking occurred during eight episodes of ictal asystole, and loss of muscle tone occurred during four. In contrast, neither bilateral limb movement nor loss of muscle tone was observed in any of the non-asystolic seizures, whether ictal bradycardia was present or not. All patients with ictal asystole reported a history of seizure-related falls and brief body and limb jerking. Conclusions: The presence of loss of muscle tone or bilateral asymmetric jerky limb movements during a seizure suggests the possibility of ictal asystole. Video-EEG/ECG monitoring should be considered in patients with epilepsy demonstrating these clinical features to determine if ictal asystole is present. Springer, 2007 epilepsy nationallicence temporal lobe nationallicence syncope nationallicence bradycardia nationallicence heart arrest nationallicence autonomic nervous system diseases nationallicence autonomic nervous system nationallicence Ghearing Gena Dept. of Neurology, Mayo Clinic Rochester, Rochester, MN, USA aut Munger Thomas Division of Cardiology, Dept. of Internal Medicine, Mayo Clinic Rochester, Rochester, MN, USA aut Jaffe Allan Division of Cardiology, Dept. of Internal Medicine, Mayo Clinic Rochester, Rochester, MN, USA aut Benarroch Eduardo Dept. of Neurology, Mayo Clinic Rochester, Rochester, MN, USA aut Britton Jeffrey Dept. of Neurology, Mayo Clinic Rochester, Rochester, MN, USA aut https://doi.org/10.1007/s10286-007-0429-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10286-007-0429-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ghearing Gena Dept. of Neurology, Mayo Clinic Rochester, Rochester, MN, USA aut NATIONALLICENCE 700 1- Munger Thomas Division of Cardiology, Dept. of Internal Medicine, Mayo Clinic Rochester, Rochester, MN, USA aut NATIONALLICENCE 700 1- Jaffe Allan Division of Cardiology, Dept. of Internal Medicine, Mayo Clinic Rochester, Rochester, MN, USA aut NATIONALLICENCE 700 1- Benarroch Eduardo Dept. of Neurology, Mayo Clinic Rochester, Rochester, MN, USA aut NATIONALLICENCE 700 1- Britton Jeffrey Dept. of Neurology, Mayo Clinic Rochester, Rochester, MN, USA aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer