Iktalna bradikardija s asistolijom u epileptičara - prikaz dvoje bolesnika [Ictal bradycardia with asystole in patients with epilepsy – a case report]

Bradić, Lada and Šimonček, Tea and Glavaš Konja, Blanka and Šegović, Marina and Lovrić Benčić, Martina (2019) Iktalna bradikardija s asistolijom u epileptičara - prikaz dvoje bolesnika [Ictal bradycardia with asystole in patients with epilepsy – a case report]. Liječnički vjesnik, 141 (1-2). pp. 20-23. ISSN 0024-3477

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Abstract

Epileptic seizures, particularly of frontotemporal origin, may cause central autonomic regulation disorder. Resulting cardiorespiratory and neurologic dysfunction can result in syncope and sudden unexpected death in epilepsy. We present two patients with temporal epilepsy and documented bradycardia/asystole during epileptic seizures with asystolic pauses lasting up to 25 seconds. Considering clinical implications, increased awareness and timely detection of concomitant arrhythmias is essential, since cardiac pacemaker implantation in case of asystole can prevent cardiogenic component of syncope, reduce risk of sudden death, falls and injuries in patients refractory to antiepileptics.

Abstract in Croatian

Epileptički napadaji, osobito frontotemporalnog ishodišta, mogu uzrokovati poremećaj središnje autonomne regulacije. Posljedična kardiorespiratorna i neurološka disfunkcija mogu dovesti do sinkope i iznenadne neočekivane smrti u epilepsiji. Prikazale smo dvoje bolesnika s temporalnom epilepsijom i dokumentiranom bradikardijom/asistolijom tijekom epileptičkog napadaja s asistoličkim pauzama u trajanju do 25 sekunda. S obzirom na kliničko značenje, nužni su veća svjesnost i pravodobno prepoznavanje popratnih srčanih aritmija, jer ugradnjom elektrostimulatora srca pri asistoliji možemo prevenirati kardiogenu komponentu sinkope te sniziti rizik od nagle smrti, padova i ozljeda u bolesnika refraktornih na antiepileptike.

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