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Cardiac Asystole and Bradycardia as a Manifestation of Left Temporal Lobe Complex Partial Seizure
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Ventricular FibrillationCardiovascular DiseaseCardiac PhysiologyMyocardial InfarctionComplex Partial SeizuresArrhythmiaCardiovascular ImagingCardiac AsystoleNeurologyAcute Myocardial InfarctionCentral Nervous SystemPublic HealthMedicineCardiologyEmergency MedicineCardiac PathologyCardiac Arrest
Brief Communications6 April 1999Cardiac Asystole and Bradycardia as a Manifestation of Left Temporal Lobe Complex Partial SeizureEduardo R. Locatelli, MD, Jacob P. Varghese, MD, Ashfaq Shuaib, MD, and Samuel J. Potolicchio, MDEduardo R. Locatelli, MDFrom George Washington University, Washington, D.C., Jacob P. Varghese, MDFrom George Washington University, Washington, D.C., Ashfaq Shuaib, MDFrom George Washington University, Washington, D.C., and Samuel J. Potolicchio, MDFrom George Washington University, Washington, D.C.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-130-7-199904060-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Sudden cardiac death is almost always associated with coronary artery disease (1), but even in coronary artery disease, the autonomic nervous system plays a significant role in the genesis of arrhythmias (2). It is well established that the central nervous system can trigger sudden death by intense activation of the autonomic nervous system (3), the release of opioids, or the release of neuroactive peptides (4). Cortical stimulation studies suggest sympathetic predominance over the right hemisphere and a parasympathetic effect on the left hemisphere (5). Cortical activity, as seen in complex partial seizures with concomitant changes in heart rate, might help ...References1. Roberts WC. Sudden cardiac death: definitions and causes. Am J Cardiol. 1986;57:1410-3. CrossrefMedlineGoogle Scholar2. Schwartz PJ, Vanoli E. Cardiac arrhythmias elicited by interaction between acute myocardial ischemia and sympathetic hyperactivity: a new experimental model for the study of antiarrhythmic drugs. J Cardiovasc Pharmacol. 1981;3:1251-9. CrossrefMedlineGoogle Scholar3. Lown B, Verrier RL. Neural activity and ventricular fibrillation. N Engl J Med. 1976;294:1165-70. CrossrefMedlineGoogle Scholar4. Levy MN, Warner MR. Autonomic interactions in cardiac control: role of neuropeptides.. In: Zipes DP, Jalife J, eds. Cardiac Electrophysiology: From Cell to Bedside. Philadelphia: WB Saunders; 1990:305. Google Scholar5. Oppenheimer SM, Gelb A, Girvin JP, Hachinski VC. Cardiovascular effects of human insular cortex stimulation. Neurology. 1992;42:1727-32. CrossrefMedlineGoogle Scholar6. Gilchrist JM. Arrhythmogenic seizures: diagnosis by simultaneous EEG/ECG recording. Neurology. 1985;35:1503-6. CrossrefMedlineGoogle Scholar7. Bertholds E, Hedström A, Rydén L. Neurogen kardiologieller kardiogen neurologi? Lakartidningen. 1988;85:24-6. Google Scholar8. Fincham RW, Shivapour ET, Leis AA, Martins JB. Ictal bradycardia with syncope: a case report. Neurology. 1992;42:2222-3. CrossrefMedlineGoogle Scholar9. Liedholm LJ, Gudjonsson O. Cardiac arrest due to partial epileptic seizures. Neurology. 1992;42:824-9. CrossrefMedlineGoogle Scholar10. Reeves AL, Nollet KE, Klass DW, Sharbrough FW, So EL. The ictal bradycardia syndrome. Epilepsia. 1996;37:983-7. CrossrefMedlineGoogle Scholar11. Devinsky O, Pacia S, Tatambhotla G. Bradycardia and asystole induced by partial seizures: a case report and literature review. Neurology. 1997;48:1712-4. CrossrefMedlineGoogle Scholar12. Jacome DE, Seroppian ER. Ictal bradycardia. Am J Med Sci. 1988;295:469-71. CrossrefMedlineGoogle Scholar13. van Rijckevorsel K, Saussu F, de Barsy T. Bradycardia, an epileptic ictal manifestation. Seizure. 1995;4:237-9. CrossrefMedlineGoogle Scholar14. Wilder-Smith E, Wilder-Smith A. Complex partial seizures as cause of transient cardiac arrhythmia. Schweiz Med Wochenschr. 1995;125:2237-43. MedlineGoogle Scholar15. Howell SJ, Blumhardt LD. Cardiac asystole associated with epileptic seizures: a case report with simultaneous EEG and ECG. J Neurol Neurosurg Psychiatry. 1989;52:795-8. CrossrefMedlineGoogle Scholar16. Swartz CM, Abrams R, Lane RD, DuBois MA, Srinivasaraghavan J. Heart rate differences between right and left unilateral electroconvulsive therapy. J Neurol Neurosurg Psychiatry. 1994;57:97-9. CrossrefMedlineGoogle Scholar17. Zamrini EY, Meador KJ, Loring DW, Nichols FT, Lee GP, Figueroa RE, Thompson WO. Unilateral cerebral inactivation produces differential left/right heart rate responses. Neurology. 1990;40:1408-11. CrossrefMedlineGoogle Scholar18. Lane RD, Wallace JD, Petrosky PP, Schwartz GE, Gradman AH. Supraventricular tachycardia in patients with right hemisphere strokes. Stroke. 1992;23:362-6. CrossrefMedlineGoogle Scholar19. Massetani R, Strata G, Galli R, Gori S, Gneri C, Limbruno U, et al . Alteration of cardiac function in patients with temporal lobe epilepsy: different roles of EEG-ECG monitoring and spectral analysis of RR variability. Epilepsia. 1997;38:363-9. CrossrefMedlineGoogle Scholar20. Thompson ME, Felsten G, Yavorsky J, Natelson BH. Differential effect of stimulation of nucleus ambiguus on atrial and ventricular rates. Am J Physiol. 1987; 253(1 Pt 2):R150-7. Google Scholar Author, Article, and Disclosure InformationAffiliations: From George Washington University, Washington, D.C.Corresponding Author: Eduardo R. Locatelli, MD, Department of Neurology, George Washington University, 2150 Pennsylvania Avenue NW, Room 7-404, Washington, DC 20037; e-mail, [email protected]circ.gwu.edu.Current Author Addresses: Drs. Locatelli, Shuaib, and Potolicchio: Department of Neurology, George Washington University, 2150 Pennsylvania Avenue NW, Room 7-404, Washington, DC 20037.Dr. Varghese: Department of Medicine, Division of Cardiology, George Washington University, 2150 Pennsylvania Avenue NW, Room 4-422, Washington, DC 20037. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCardiac Asystole and Bradycardia as a Manifestation of Left Temporal Lobe Complex Partial Seizure Michael D. 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Weinstein, MD and Claude Albertario, RPSGT 6 April 1999Volume 130, Issue 7Page: 581-583KeywordsAnticonvulsantsBradycardiaElectroencephalographyEpileptic seizuresHeartHeart ratePacemakersPatient advocacySyncopeTemporal lobe Issue Published: 6 April 1999 CopyrightCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
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