Management and long-term outcome in patients presenting with ictal asystole or bradycardia.


PURPOSE:Ictal asystole (IA) and ictal bradycardia (IB) are rare autonomic symptoms during epileptic seizures and may be potentially life-threatening. Guidelines for the care of these patients are missing. The aim of this multicenter study was to evaluate the management and long-term outcome in patients with IA and IB. PATIENTS AND METHODS:All patients with IA and IB were included from four epilepsy centers (Bielefeld, Kork, Marburg, and Zürich) from 2002 until 2009. Using a standardized assessment form, clinical data, treatment decisions, and outcomes were extracted from patient charts and simultaneous electroencephalography/electrocardiography (EEG/ECG) recordings. KEY FINDINGS:Seizures with IA or IB were identified in 16 patients. In all patients an associated temporal seizure pattern was recorded and in 15 patients, sudden falls, fainting, or trauma was previously reported or recorded during the monitoring. In three patients (18.8%) diagnosis of focal epilepsy was newly established and anticonvulsive treatment was initiated. Two patients with refractory epilepsy underwent epilepsy surgery. In seven patients (43.8%) a cardiac pacemaker was implanted. In 14 of 16 treated patients, seizure freedom (n = 5) or absence of sudden falls, fainting, or trauma (n = 9) could be achieved. Two patients denied epilepsy surgery as well as a pacemaker and continue to have frequent falls and trauma. SIGNIFICANCE:Our study demonstrates that epilepsy surgery and antiepileptic drugs may lead to sustained freedom of seizures as well as ictal syncope. In drug-resistant patients not suitable for epilepsy surgery, implantation of a cardiac pacemaker may prevent sudden falls as well as trauma. Based on our results and previously reported cases we propose a treatment algorithm.






Strzelczyk A,Cenusa M,Bauer S,Hamer HM,Mothersill IW,Grunwald T,Hillenbrand B,Ebner A,Steinhoff BJ,Krämer G,Rosenow F




Has Abstract


2011-06-01 00:00:00












  • NMDA-receptors 1 and 2A/B coassembly increased in human epileptic focal cortical dysplasia.

    abstract:PURPOSE:This study was designed to quantify the relation between expressions of NMDA receptor (NMDAR) subunits (1 and 2A/B) and the epileptogenicity in human focal cortical dysplasia. METHODS:Immunoblotting and immunoprecipitation were used to quantify these receptor subunits in tissue resected from EEG-verified epile...


    pub_type: 杂志文章


    authors: Mikuni N,Babb TL,Ying Z,Najm I,Nishiyama K,Wylie C,Yacubova K,Okamoto T,Bingaman W

    更新日期:1999-12-01 00:00:00

  • Facial asymmetry in partial epilepsies.

    abstract::Fifty-six consecutive epileptic patients with partial seizures (30 temporal, 26 extratemporal) and facial asymmetry were studied. Facial asymmetry was compared with EEG, radiologic, and other clinical findings. Thirty patients had a lesional epilepsy whereas 26 were considered cryptogenic. In lesional epilepsies, 60% ...


    pub_type: 杂志文章


    authors: Tinuper P,Plazzi G,Provini F,Cerullo A,Leonardi M,Agati R,Righini A,Montagna P

    更新日期:1992-11-01 00:00:00

  • The new antiepileptic drugs and women: efficacy, reproductive health, pregnancy, and fetal outcome.

    abstract::As new antiepileptic drugs (AEDs) become available, physicians will define their appropriate use in particular patient populations. For women, the issues include gender-specific efficacy and tolerability, including the impact of the AED on reproductive health. Women with epilepsy who are treated with established AEDs ...


    pub_type: 杂志文章,评审


    authors: Morrell MJ

    更新日期:1996-01-01 00:00:00

  • A study of the pharmacokinetics of phenytoin (diphenylhydantoin) in epileptic patients, and the development of a nomogram for making dose increments.

    abstract::Phenytoin is metabolized to its parahydroxylated derivative by hepatic microsomal enzymes. This hydroxylation is a saturable process, that is, the rate of metabolism fails to increase in proportion to the serum concentration. This leads to a nonlinear relationship between the maintenance dose of the drug and the resul...


    pub_type: 杂志文章


    authors: Richens A

    更新日期:1975-11-01 00:00:00

  • A kindling-like effect induced by repeated exposure to heated water in rats.

    abstract::Hyperthermia was induced in mature rats by immersing them in 20 cm of 45 degrees C water for 4 min. Rats were made hyperthermic once every 4 days for six exposures. A significant number had at least one convulsion by the third exposure. During the seventh exposure, 2 weeks after the sixth exposure, twice as many rats ...


    pub_type: 杂志文章


    authors: Klauenberg BJ,Sparber SB

    更新日期:1984-06-01 00:00:00

  • How phenobarbital revolutionized epilepsy therapy: the story of phenobarbital therapy in epilepsy in the last 100 years.

    abstract::Phenobarbital (phenobarbitone) was first used as an antiepileptic drug 100 years ago, in 1912. This article tells the story of the discovery of its antiepileptic action, its early development, and the subsequent course of its clinical use over the 100-year period. The side effects, pharmacokinetics, and misuse of barb...


    pub_type: 历史文章,杂志文章


    authors: Yasiry Z,Shorvon SD

    更新日期:2012-12-01 00:00:00

  • Decreased cerebrospinal fluid hypocretin-1 (orexin A) in patients after repetitive generalized tonic-clonic seizures.

    abstract::The effects of seizures on the hypocretin/orexin system have not yet been investigated in epileptic patients. The present study aimed to assay hypocretin-1 in the cerebrospinal fluid (CSF) of patients after generalized tonic-clonic (GTC) seizures. Study groups consisted of 21 patients after GTC seizures and 19 control...


    pub_type: 杂志文章


    authors: Rejdak K,Papuć E,Grieb P,Stelmasiak Z

    更新日期:2009-06-01 00:00:00

  • Epilepsy, seizures, physical exercise, and sports: A report from the ILAE Task Force on Sports and Epilepsy.

    abstract::People with epilepsy (PWEs) are often advised against participating in sports and exercise, mostly because of fear, overprotection, and ignorance about the specific benefits and risks associated with such activities. Available evidence suggests that physical exercise and active participation in sports may favorably af...


    pub_type: 杂志文章


    authors: Capovilla G,Kaufman KR,Perucca E,Moshé SL,Arida RM

    更新日期:2016-01-01 00:00:00

  • Eyelid myoclonia with absences (Jeavons syndrome): a well-defined idiopathic generalized epilepsy syndrome or a spectrum of photosensitive conditions?

    abstract::Eyelid myoclonia with absences (EMA), or Jeavons syndrome, is a generalized epileptic condition clinically characterized by eyelid myoclonia (EM) with or without absences, eye closure-induced electroencephalography (EEG) paroxysms, and photosensitivity; in addition, rare tonic-clonic seizures may also occur. Although ...


    pub_type: 杂志文章,评审


    authors: Striano S,Capovilla G,Sofia V,Romeo A,Rubboli G,Striano P,Trenité DK

    更新日期:2009-05-01 00:00:00

  • Febrile seizures: clinical characteristics and initial EEG.

    abstract::We examined the relationship between clinical characteristics and EEG classification in all children with febrile seizures examined at the University Pediatric Clinic, Skopje, Yugoslavia between 1982 and 1984. This is the only facility in Macedonia providing EEG or neurologic consultation for children. EEGs were class...


    pub_type: 杂志文章


    authors: Sofijanov N,Emoto S,Kuturec M,Dukovski M,Duma F,Ellenberg JH,Hirtz DG,Nelson KB

    更新日期:1992-01-01 00:00:00

  • Effects of age on seizure susceptibility in genetically epilepsy-prone rats (GEPR-9s).

    abstract::To study the effect of age on seizure latency, intensity, reproducibility, and mortality in genetically epilepsy-prone rats of the severe colony (GEPR-9s), 472 seizure-naive rats, ranging in age from 14 to 65 days, received a series of three audiogenic stimulations. Both the percentage of rats having one or more seizu...


    pub_type: 杂志文章


    authors: Thompson JL,Carl FG,Holmes GL

    更新日期:1991-03-01 00:00:00

  • Late-onset periodic asystolia during vagus nerve stimulation.

    abstract::Cardiac changes may occasionally occur during vagus nerve stimulation (VNS) used in epileptic patients. As they can be potentially life-threatening, it is important to detect them, and this is why an intraoperative test is performed during the implantation. Few cases of asystole during this test have been described. O...


    pub_type: 杂志文章


    authors: Iriarte J,Urrestarazu E,Alegre M,Macías A,Gómez A,Amaro P,Artieda J,Viteri C

    更新日期:2009-04-01 00:00:00

  • Estrogen treatment protects GABA(B) inhibition in the dentate gyrus of female rats after kainic acid-induced status epilepticus.

    abstract:PURPOSE:We used the paired-pulse inhibition paradigm to determine whether the cell loss in the hilus of the dentate gyrus of female rats after kainic acid (KA)-induced status epilepticus (SE) is associated with functional changes in the dentate gyrus. Additionally, we determined whether the lost function could be prese...


    pub_type: 杂志文章


    authors: Velísek L,Velísková J

    更新日期:2002-01-01 00:00:00

  • Altered behavior in experimental cortical dysplasia.

    abstract:PURPOSE:Developmental delay and cognitive impairment are common comorbidities in people with epilepsy associated with malformations of cortical development (MCDs). We studied cognition and behavior in an animal model of diffuse cortical dysplasia (CD), in utero irradiation, using a battery of behavioral tests for neuro...


    pub_type: 杂志文章


    authors: Zhou FW,Rani A,Martinez-Diaz H,Foster TC,Roper SN

    更新日期:2011-12-01 00:00:00

  • Provocation of nonepileptic seizures by suggestion in a general seizure population.

    abstract::Nonepileptic seizures (NES) are common and are often diagnosed at epilepsy centers by video-EEG recording of both spontaneous and suggestion-induced episodes, but no study has evaluated provocative testing in a general seizure population. We studied consecutive patients with a tentative diagnosis of epilepsy using sal...


    pub_type: 杂志文章


    authors: Bazil CW,Kothari M,Luciano D,Moroney J,Song S,Vasquez B,Weinreb HJ,Devinsky O

    更新日期:1994-07-01 00:00:00

  • Rapid switchover to carbamazepine using pharmacokinetic parameters.

    abstract:PURPOSE:The standard practice of switching patients to carbamazepine (CBZ) involves initiating a low dose and raising it by small increments until the desired dose is reached, to avoid intolerable adverse effects (AE). In a pilot study, a protocol using single-dose kinetic studies was developed to switch patients to CB...


    pub_type: 杂志文章


    authors: Kanner AM,Bourgeois BF,Hasegawa H,Hutson P

    更新日期:1998-02-01 00:00:00

  • Neonatal seizures: problems in diagnosis and classification.

    abstract::The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroence...


    pub_type: 杂志文章,评审


    authors: Mizrahi EM

    更新日期:1987-01-01 00:00:00

  • Evidence for a role of the parafascicular nucleus of the thalamus in the control of epileptic seizures by the superior colliculus.

    abstract:PURPOSE:The aim of this study was to investigate whether the nucleus parafascicularis (Pf) of the thalamus could be a relay of the control of epileptic seizures by the superior colliculus (SC). The Pf is one of the main ascending projections of the SC, the disinhibition of which has been shown to suppress seizures in d...


    pub_type: 杂志文章


    authors: Nail-Boucherie K,Lê-Pham BT,Gobaille S,Maitre M,Aunis D,Depaulis A

    更新日期:2005-01-01 00:00:00

  • The progression of electrophysiologic abnormalities during epileptogenesis after experimental traumatic brain injury.

    abstract:OBJECTIVE:Posttraumatic epilepsy (PTE) accounts for 20% of acquired epilepsies. Experimental models are important for studying epileptogenesis. We previously reported that repetitive high-frequency oscillations with spikes (rHFOSs) occur early after lateral fluid percussion injury (FPI) and may be a biomarker for PTE. ...


    pub_type: 杂志文章


    authors: Reid AY,Bragin A,Giza CC,Staba RJ,Engel J Jr

    更新日期:2016-10-01 00:00:00

  • Benzodiazepine receptors and their relationship to the treatment of epilepsy.

    abstract::Benzodiazepines (BDZ) interact with components of neuronal membranes to modify excitability in three different ways. Action at a high affinity central receptor (dissociation constant, KD, of 3 nM) linked to the GABAA recognition site enhances the inhibitory action of GABA by increasing the number of openings of Cl- ch...


    pub_type: 杂志文章


    authors: Meldrum BS,Chapman AG

    更新日期:1986-01-01 00:00:00

  • Bioequivalence of oral and intravenous carbamazepine formulations in adult patients with epilepsy.

    abstract:OBJECTIVE:To evaluate the safety, tolerability, and comparative pharmacokinetics (PK) of intravenous and oral carbamazepine. METHODS:In this phase 1, open-label study, adult patients with epilepsy on a stable oral carbamazepine dosage (400-2,000 mg/day) were converted to intravenous carbamazepine (administered at 70% ...


    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Tolbert D,Cloyd J,Biton V,Bekersky I,Walzer M,Wesche D,Drummond R,Lee D

    更新日期:2015-06-01 00:00:00

  • A comparison of two methods for estimating the health care costs of epilepsy.

    abstract:PURPOSE:Previous studies have estimated medical care costs of epilepsy by applying unit costs to estimated utilization or by summing costs for (a) ambulatory care and hospitalizations coded as epilepsy and (b) procedures and drugs specifically associated with the diagnosis or treatment of epilepsy. These methods may un...


    pub_type: 杂志文章


    authors: Frost FJ,Hurley JS,Petersen HV,Gunter MJ,Gause D

    更新日期:2000-08-01 00:00:00

  • Neuroimaging in identifying focal cortical dysplasia and prognostic factors in pediatric and adolescent epilepsy surgery.

    abstract:PURPOSE:The purpose of this study is to determine the sensibility of each imaging tool in identifying focal cortical dysplasia (FCD) in children and adolescents with epilepsy and to define the prognostic factors of pediatric and adolescent epilepsy surgery. METHODS:We identified 48 children with FCD who underwent rese...


    pub_type: 杂志文章


    authors: Kim YH,Kang HC,Kim DS,Kim SH,Shim KW,Kim HD,Lee JS

    更新日期:2011-04-01 00:00:00

  • Diagnostic utility of invasive EEG for epilepsy surgery: Indications, modalities, and techniques.

    abstract::Many patients with medically refractory epilepsy now undergo successful surgery based on noninvasive diagnostic information, but intracranial electroencephalography (IEEG) continues to be used as increasingly complex cases are considered surgical candidates. The indications for IEEG and the modalities employed vary ac...


    pub_type: 杂志文章


    authors: Jayakar P,Gotman J,Harvey AS,Palmini A,Tassi L,Schomer D,Dubeau F,Bartolomei F,Yu A,Kršek P,Velis D,Kahane P

    更新日期:2016-11-01 00:00:00

  • Systemic lupus erythematosus associated with use of valproate.

    abstract::A 30-year-old man with long-standing localization-related epilepsy and mental retardation had seizures that were partially controlled with valproate (VPA) 500 mg four times daily. Routine examination showed severe thrombocytopenia with mild leukopenia and chronic low-grade hemolytic anemia. Pertinent laboratory result...


    pub_type: 杂志文章


    authors: Asconapé JJ,Manning KR,Lancman ME

    更新日期:1994-01-01 00:00:00

  • Effects of new antiepileptic drugs on circulatory markers for vascular risk in patients with newly diagnosed epilepsy.

    abstract::Although it is well documented that long-term therapy with older antiepileptic drugs (AEDs) leads to an increase in risk for atherosclerosis, there has been only limited information regarding the vascular risk in patients who are treated with new AEDs. We therefore conducted a prospective longitudinal study to assess ...


    pub_type: 杂志文章


    authors: Kim DW,Lee SY,Shon YM,Kim JH

    更新日期:2013-10-01 00:00:00

  • Distribution of pyramidal cell density and hyperexcitability in the epileptic human hippocampal formation.

    abstract::Pyramidal cell densities in various regions of the anterior and posterior hippocampal formation were measured from en bloc temporal lobe resections and compared with presurgical stereoelectroencephalography (SEEG) data derived from depth electrodes in 12 patients with temporal lobe epilepsy. These data were compared w...


    pub_type: 杂志文章


    authors: Babb TL,Lieb JP,Brown WJ,Pretorius J,Crandall PH

    更新日期:1984-12-01 00:00:00

  • A neuropsychological battery for epilepsy.

    abstract::The development of the Neuropsychological Battery for Epilepsy is presented. The tests are designed to be helpful in the evaluation of adult epileptics. The battery consists of General Measures which include tests in the areas of intellectual functioning, emotional status, and lateral dominance. The development of a s...


    pub_type: 杂志文章


    authors: Dodrill CB

    更新日期:1978-12-01 00:00:00

  • Time trends in incidence, mortality, and case-fatality after first episode of status epilepticus.

    abstract:PURPOSE:Status epilepticus (SE) is a medical emergency associated with a high mortality. Clinical series have suggested that mortality after SE has decreased. No studies have systematically examined trends in incidence, mortality, and case fatality after SE in a well-defined population. METHODS:All first episodes of S...


    pub_type: 杂志文章


    authors: Logroscino G,Hesdorffer DC,Cascino G,Annegers JF,Hauser WA

    更新日期:2001-08-01 00:00:00

  • Analysis of a quantitative trait locus for seizure susceptibility in mice using bacterial artificial chromosome-mediated gene transfer.

    abstract:PURPOSE:Previous quantitative trait loci (QTL) mapping studies from our laboratory identified a 6.6 Mb segment of distal chromosome 1 that contains a gene (or genes) having a strong influence on the difference in seizure susceptibility between C57BL/6 (B6) and DBA/2 (D2) mice. A gene transfer strategy involving a bacte...


    pub_type: 杂志文章


    authors: Ferraro TN,Golden GT,Dahl JP,Smith GG,Schwebel CL,MacDonald R,Lohoff FW,Berrettini WH,Buono RJ

    更新日期:2007-09-01 00:00:00