142 Ictal asystole case series

Ictal arrhythmias are disturbances of cardiac conduction that occur during clinical or electrographic seizures. Ictal asystole is rare and its incidence can range from 0.3–0.4 % in patients with epilepsy.We reported eleven patients (Seven males and four females) with an age range (31–70 years old) who were monitored in our telemetry unit over the last eight years. Patients were selected based on the history of documented ictal asystole or bradycardia during inpatient VEEG monitoring). In our series the mean latency was 22 seconds and the mean duration of the ictal asystole was 15.8 seconds. During the asystolic phase the seizures may clinically continue or syncopal signs may take over.We found two patterns in ictal semiology in our series. The first group of patients included three patients who experienced a rapid onset of ictal asystole in their seizure and the second group where the latency of ictal asystole was relatively late. Both groups of patients have temporal lobe epilepsy.In our case series all the patients had either left or right temporal lobe epilepsy, six of which were lesional. Ten of our cohort had permanent pace maker following the diagnosis, Six of which had been event free since.dm.neuro@hotmail.com