Iatrogenic ictal asystole.


Journal

Journal of the neurological sciences
ISSN: 1878-5883
Titre abrégé: J Neurol Sci
Pays: Netherlands
ID NLM: 0375403

Informations de publication

Date de publication:
15 Mar 2022
Historique:
received: 12 11 2021
revised: 14 01 2022
accepted: 04 02 2022
pubmed: 14 2 2022
medline: 14 4 2022
entrez: 13 2 2022
Statut: ppublish

Résumé

Sodium channels blockers are widely used in focal epilepsies. Beyond frequent and recognized adverse events, a possible influence in cardiac conduction has rarely been hypothesized. Cardiac asystolia is a rare complication of seizures: exact etiology is far from being clarified. Here we report two cases of focal pharmacoresistant epilepsy complicated by ictal asystole which occurred only in the course of treatment with carbamazepine and phenytoin. The clear relationship between ictal arrhythmia and sodium channels blockers may be related to the negative chronotropic and inotropic cardiac effects. Ictal asystole may exacerbate falls in epileptic populations and requires rapid therapeutic decisions. Iatrogenic causes must be added in the therapeutic algorithm.

Sections du résumé

BACKGROUND BACKGROUND
Sodium channels blockers are widely used in focal epilepsies. Beyond frequent and recognized adverse events, a possible influence in cardiac conduction has rarely been hypothesized. Cardiac asystolia is a rare complication of seizures: exact etiology is far from being clarified.
METHOD AND RESULTS RESULTS
Here we report two cases of focal pharmacoresistant epilepsy complicated by ictal asystole which occurred only in the course of treatment with carbamazepine and phenytoin.
CONCLUSIONS CONCLUSIONS
The clear relationship between ictal arrhythmia and sodium channels blockers may be related to the negative chronotropic and inotropic cardiac effects. Ictal asystole may exacerbate falls in epileptic populations and requires rapid therapeutic decisions. Iatrogenic causes must be added in the therapeutic algorithm.

Identifiants

pubmed: 35151939
pii: S0022-510X(22)00045-4
doi: 10.1016/j.jns.2022.120183
pii:
doi:

Substances chimiques

Sodium Channels 0

Types de publication

Case Reports Letter

Langues

eng

Sous-ensembles de citation

IM

Pagination

120183

Informations de copyright

Copyright © 2022 Elsevier B.V. All rights reserved.

Auteurs

Elena Pasini (E)

IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy. Electronic address: elena.pasini@isnb.it.

Patrizia Riguzzi (P)

IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.

Roberto Michelucci (R)

IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.

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Classifications MeSH