Diagnostic Role of ECG Recording Simultaneously With EEG Testing

Area of Science:

• Neurology
• Cardiology
• Clinical Neurophysiology

Background:

• Syncope (fainting) can mimic epilepsy, and arrhythmias (irregular heartbeats) are a common cause.
• Epilepsy-induced vagal tone abnormalities are increasingly recognized.
• Neurologists often perform electroencephalogram (EEG) testing for suspected epilepsy.

Purpose of the Study:

• To evaluate the diagnostic yield for neurologists of simultaneous electrocardiogram (ECG) and EEG recordings.
• To identify ECG abnormalities in patients undergoing EEG for suspected epilepsy.
• To clarify the clinical relevance of coexisting ECG and EEG abnormalities.

Main Methods:

• Retrospective evaluation of 376 patients undergoing EEG testing.
• Simultaneous 1-channel ECG recording during a minimum of 20 minutes of artifact-free EEG.
• Analysis of ECG abnormalities in relation to patient demographics and EEG findings.

Main Results:

• ECG abnormalities were detected in 18% (68/376) of patients.
• Females (28%) showed higher rates of ECG abnormalities than males (14%), with different prevalent arrhythmias.
• One case of critical asystole indicating sick sinus syndrome was identified in a female patient, leading to pacemaker implantation.

Conclusions:

• Simultaneous ECG and EEG recording is crucial for detecting and clarifying coexisting cardiac and neurological abnormalities.
• This combined approach can differentiate syncope mimicking seizures from epilepsy.
• It helps identify potentially life-threatening conditions and guides appropriate treatment, distinguishing them from epilepsy or seizure mimics.