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Potentially Life-Threatening Ictal Bradycardia in Intractable Epilepsy

Published online by Cambridge University Press:  02 December 2014

Céline Odier
Affiliation:
Department of Medicine, Neurology Division, Montreal University Health Centre (CHUM), Montreal, Quebec, Canada
Dang Khoa Nguyen
Affiliation:
Department of Medicine, Neurology Division, Montreal University Health Centre (CHUM), Montreal, Quebec, Canada
Alain Bouthillier
Affiliation:
Department of Medicine, Neurology Division, Montreal University Health Centre (CHUM), Montreal, Quebec, Canada
Normand Giard
Affiliation:
Department of Medicine, Neurology Division, Montreal University Health Centre (CHUM), Montreal, Quebec, Canada
Jean-Marc Saint-Hilaire
Affiliation:
Department of Medicine, Neurology Division, Montreal University Health Centre (CHUM), Montreal, Quebec, Canada
Patrick Cossette
Affiliation:
Department of Medicine, Neurology Division, Montreal University Health Centre (CHUM), Montreal, Quebec, Canada
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Abstract

Background:

Recently a high prevalence of asystole was found in individuals with refractory epilepsy.

Objective:

To measure the prevalence and characterize the pattern of ictal bradycardia (IB) in our cohort.

Method:

We analyzed ictal heart rate (HR) and seizure localization in 69 consecutive individuals with intractable epilepsy. Ictal bradycardia was defined by HR less than 60 beat per min (bpm) and a fall of more than 30 bpm.

Results:

Ictal bradycardia was observed in 1.9% of seizures and in five individuals (7.2%), who presented IB in 5.7% of their seizures. Four of them had also relative IB (a decrease of HR of more than10 bpm) in the majority of their seizures. Four additional individuals showed relative IB.

Conclusion:

Ictal bradycardia occurs more frequently than previously thought in individuals with refractory epilepsy. Recognition of individuals with small to moderate ictal HR decrease may help to identify those at greatest risk for asystole.

Type
Research Article
Copyright
Copyright © The Canadian Journal of Neurological 2009

References

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