ASYSTOLIC SEIZURES

Epileptic seizures may alter autonomic functions. This is especially t he case with complex focal seizures (of temporal lobe origin) and gran d mal. Most frequently, such seizures cause ictal tachycardia, sometim es tachypnea, probably caused by the propagation of epileptic discharg es to autonomic cerebral structures. Ictal bradycardia and asystole ar e rare phenomena. However, they may be life threatening. Their differe ntiation from primary cardiac arrest is possible by the use of ictal E EG and ECG registration. Postictal serum prolactin measurement does no t differentiate syncope from seizure. However, a postictal increase of creatine kinase is only measured after epileptic seizures and not aft er syncope. Treatment of such epileptic seizures includes an optimizat ion of anticonvulsant drug therapy and the implantation of a cardiac d emand stimulator. There is growing evidence that ictal asystole is a c ofactor in sudden unexplained death in epileptic patients.