Self-limiting symptomatic peri-ictal bradyarryhthmia due to junctional AV rhythm

Address for correspondence: Dr. Sanjib Sinha National Institute of Mental Health and Neurosciences Hosur Road, Bangalore, Karnataka India sanjib_sinha2004@yahoo.co.in

Journal of Neurosciences in Rural Practice

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Abstract

ABSTRACT

We report an elderly man with chronic uncontrolled localization.related epilepsy on three AEDs, who developed in.hospital symptomatic bradyarrythmia due to junctional atrio-ventricular (AV) rhythm after an episode of generalized seizure during his hospital stay. On further evaluation, the cardiac enzymes were normal and 2D.echocardiogram showed mild left ventricular hypertrophy. Patient recovered from the same with supportive treatment within few hours. We emphasize on importance of prompt recognition of this event and its implication including one of the mechanism for sudden unexplained death in epilepsy.

Keywords

Bradyarrythmia

epilepsy

sudden unexplained death in epilepsy

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Conflict of Interest

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References

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Surges R, Moskau S, Viebahn B, Schoene-Bake J. C., Schwab J. O., Elger C. E., . Prolonged atrial fibrillation following generalized tonic-clonic seizures. Seizure. 2012;21:643-5.
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[1] Ficker D. M., So E. L., Shen W. K., Annegers J. F., O’Brien P. C., Cascino G. D., et al . Population-based study of the incidence of sudden unexplained death in epilepsy. Neurology. 1998;51:1270-4.
[Google Scholar]

[2] Tellez-Zenteno J. F., Ronquillo L. H., Wiebe S, . Sudden unexpected death in epilepsy: Evidence-based analysis of incidence and risk factors. Epilepsy Res. 2005;65:101-15.
[Google Scholar]

[3] Dasheiff R. M., Dickinson L. J., . Sudden unexpected death of epileptic patient due to cardiac arrhythmia after seizure. Arch Neurol. 1986;43:194-6.
[Google Scholar]

[4] Bateman L. M., Spitz M, Seyal M, . Ictal hypoventilation contributes to cardiac arrhythmia and SUDEP: Report on two deaths in video-EEG-monitored patients. Epilepsia. 2010;51:916-20.
[Google Scholar]

[5] Devinsky O, Perrine K, Theodore W. H., . Interictal autonomic nervous systems function in patients with epilepsy. Epilepsia. 1994;35:199-204.
[Google Scholar]

[6] Sathyaprabha T. N., Satishchandra P, Netravathi K, Sinha S, Thennarasu K, Raju T. R., . Cardiac autonomic dysfunction in chronic refractory epilepsy. Epilepsy Res. 2006;72:49-56.
[Google Scholar]

[7] Nashef L, . Sudden unexpected death in epilepsy: Terminology and definitions. Epilepsia. 1997;38:S6-8.
[Google Scholar]

[8] Ryvlin P, Tomson T, Montavont A, . Excess mortality and sudden unexpected death in epilepsy. Presse Med. 2009;38:905-10.
[Google Scholar]

[9] Walker F, Fish D. R., . Recording respiratory parameters in patients with epilepsy. Epilepsia. 1997;38:41-2. Suppl 11
[Google Scholar]

[10] Seeck M, Blanke O, Jallon P, Picard F, Zaim S, . Symptomatic postictal cardiac asystole in a young patient with partial seizures. Europace. 2001;3:247-52.
[Google Scholar]

[11] Schuele S. U., Bermeo A. C., Alexopoulos A. V., Locatelli E. R., Burgess R. C., Dinner D. S., et al . Videoelectrographic and clinical features in patients with ictal asystole. Neurology. 2007;69:434-41.
[Google Scholar]

[12] Spyer K. M., . Central nervous control of the cardiovascular system.Autonomic failure. (3 rd ed). In: editors Oxford: Oxford University Press; 1992. p. 55-77.
[Google Scholar]

[13] Opherk C, Coromilas J, Hirsch L. J., . Heart rate and EKG changes in 102 seizures: Analysis of influencing factors. Epilepsy Res. 2002;52:117-27.
[Google Scholar]

[14] Surges R, Moskau S, Viebahn B, Schoene-Bake J. C., Schwab J. O., Elger C. E., . Prolonged atrial fibrillation following generalized tonic-clonic seizures. Seizure. 2012;21:643-5.
[Google Scholar]

[15] Herskovitz M, Schiller Y, . Atrial fibrillation associated with epileptic seizures. Arch Neurol. 2012;69:1197-9.
[Google Scholar]