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Electrocardiographic changes during electrographic seizures.

M J Keilson1, W A Hauser, J P Magrill

  • 1Division of Neurology, Maimonides Medical Center, Brooklyn, NY 11219.

Archives of Neurology
|November 1, 1989
PubMed
Summary

Ictal tachycardia is common during electrographic seizures in epilepsy patients, occurring in 96% of cases. High-risk cardiac arrhythmias, however, were rarely observed during these seizure events.

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Area of Science:

  • Neurology
  • Cardiology
  • Epilepsy Research

Background:

  • Sudden unexpected death in epilepsy (SUDEP) is a concern.
  • Cardiac arrhythmias during seizures are a proposed SUDEP mechanism.
  • Anecdotal reports suggest cardiac irregularities during seizures.

Purpose of the Study:

  • To investigate the occurrence and characteristics of cardiac arrhythmias during electrographic seizures.
  • To determine the frequency of ictal tachycardia and other cardiac irregularities.
  • To assess the relationship between seizure type and cardiac events.

Main Methods:

  • Simultaneous 24-hour electroencephalography (EEG) and electrocardiography (ECG) were used.
  • Ambulatory cassette monitoring was performed in 45 epilepsy patients.

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  • 106 electrographic seizures were analyzed for cardiac events.

    • Main Results:

    • Ictal tachycardia occurred in 96% of analyzed seizures.
    • Heart rate increased by a mean of 60% during seizures.
    • Tachycardia onset was rapid and often persisted post-ictally.
    • No ventricular ectopia, conduction defects, or bradycardia were observed.
    • No difference in cardiac events was noted between lateralized and generalized seizures.

    Conclusions:

    • Ictal tachycardia is a common finding during electrographic seizures.
    • High-risk cardiac arrhythmias are uncommon during electrographic seizures.
    • The findings suggest ictal tachycardia is the rule, not the exception.