Arrhythmias caused by seizures, either directly (experiments support a direct CNS effect on heart rhythm) or indirectly secondary to seizure induced apnea.
In a recent study by Schule et al, 0.27% of 6,825 epileptic patients who underwent video-EEG and cardiac monitoring experienced ictal asystole as defined by an RR interval of 3 seconds or greater. Of the 10 patients with asystole found by Scheule, 8 had temporal lobe epilepsy and 2 had extratemporal lobe epilepsy.
What's this mean for our daily practice?
In some rare instances, the treatment for recurrent bradycardia or asystole may be antiepileptics.
Source
Schuele, S et al. "Video-electrographic and clinical features in patients with ictal asystole" Neurology. 2007 July 31.
So, N., Sperling, M. "Ictal asystole and SUDEP" Neurology. 2007 July 31.
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