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Ictal Bradycardia
Ictal bradycardia is when people with temporal lobe epilepsy experience bradycardia with their seizures (epileptic discharges). Bradycardia is defined by a slower than normal heart rate, less than 60 bpm. (Normal range is 60-100 bpm). Ictal epileptic discharges can effect changes in cardiac rhythm. An increase in heart rhythm is common during seizures. This type of epileptic seizure is known as ictal tachycardia, in which the subject's heart rate increase of more than 10 beats per minute of above the baseline. In comparison, ictal bradycardia causes epileptic discharges that disrupt the normal cardiac rhythm in a negative fashion. Slowing the heart beat down by more than 10 beats per minute below the average baseline. Ictal bradycardia is a potential cause or reason for ictal asystole to occur and is believed to help explain the phenomenon of sudden unexpected death in epilepsy (SUDEP).Through the simultaneous use of electroencephalograph (EEG) and electrocardiograms El ...
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Seizure
A seizure is a sudden, brief disruption of brain activity caused by abnormal, excessive, or synchronous neuronal firing. Depending on the regions of the brain involved, seizures can lead to changes in movement, sensation, behavior, awareness, or consciousness. Symptoms vary widely. Some seizures involve subtle changes, such as brief lapses in attention or awareness (as seen in absence seizures), while others cause generalized convulsions with loss of consciousness ( tonic–clonic seizures). Most seizures last less than two minutes and are followed by a postictal period of confusion, fatigue, or other symptoms. A seizure lasting longer than five minutes is a medical emergency known as status epilepticus. Seizures are classified as provoked, when triggered by a known cause such as fever, head trauma, or metabolic imbalance, or unprovoked, when no immediate trigger is identified. Recurrent unprovoked seizures define the neurological condition epilepsy. Clinical features Seizur ...
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Temporal Lobe Epilepsy
In the field of neurology, temporal lobe epilepsy is an enduring brain disorder that causes unprovoked seizures from the temporal lobe. Temporal lobe epilepsy is the most common type of focal onset epilepsy among adults. Seizure symptoms and behavior distinguish seizures arising from the mesial (medial) temporal lobe from seizures arising from the lateral (neocortical) temporal lobe. Memory and psychiatric comorbidities may occur. Diagnosis relies on electroencephalographic (EEG) and neuroimaging studies. Anticonvulsant medications, epilepsy surgery, and dietary treatments may improve seizure control. Types Under the International League Against Epilepsy (ILAE) 2017 classification of the epilepsies, focal onset epilepsy occurs from seizures arising from a biological neural network within a single cerebral hemisphere. Temporal lobe epilepsy occurs from seizures arising within the temporal lobe. Temporal lobe epilepsy is the most common focal onset epilepsy, and 80% of ...
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Bradycardia
Bradycardia, also called bradyarrhythmia, is a resting heart rate under 60 beats per minute (BPM). While bradycardia can result from various pathological processes, it is commonly a physiological response to cardiovascular conditioning or due to asymptomatic type 1 atrioventricular block. Resting heart rates of less than 50 BPM are often normal during sleep in young and healthy adults and athletes. In large population studies of adults without underlying heart disease, resting heart rates of 45–50 BPM appear to be the lower limits of normal, dependent on age and sex. Bradycardia is most likely to be discovered in the elderly, as age and underlying cardiac disease progression contribute to its development. Bradycardia may be associated with symptoms of fatigue, dyspnea, dizziness, confusion, and syncope due to reduced blood flow to the brain. The types of symptoms often depend on the etiology of the slow heart rate, classified by the anatomical location of a dysfunctio ...
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Heart Rate
Heart rate is the frequency of the cardiac cycle, heartbeat measured by the number of contractions of the heart per minute (''beats per minute'', or bpm). The heart rate varies according to the body's Human body, physical needs, including the need to absorb oxygen and excrete carbon dioxide. It is also modulated by numerous factors, including (but not limited to) genetics, physical fitness, Psychological stress, stress or psychological status, diet, drugs, hormonal status, environment, and disease/illness, as well as the interaction between these factors. It is usually equal or close to the pulse rate measured at any peripheral point. The American Heart Association states the normal resting adult human heart rate is 60–100 bpm. An ultra-trained athlete would have a resting heart rate of 37–38 bpm. ''Tachycardia'' is a high heart rate, defined as above 100 bpm at rest. ''Bradycardia'' is a low heart rate, defined as below 60 bpm at rest. When a human sleeps, a heartbeat with ra ...
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Ictal
The postictal state is the altered state of consciousness after an epileptic seizure. It usually lasts between 5 and 30 minutes, but sometimes longer in the case of larger or more severe seizures, and is characterized by drowsiness, confusion, nausea, hypertension, headache or migraine, and other disorienting symptoms. The ictal period is the seizure itself; the interictal period is the time between seizures, when brain activity is more normal; and the preictal period is the time leading up to a seizure: * ''Ictal period'' refers to a physiologic state or event such as a seizure, stroke, or headache. The word originates from the Latin word ''ictus'', meaning a blow or a stroke. In electroencephalography (EEG), the recording during a seizure is said to be "ictal". The following definitions refer to the temporal relation with seizures. * ''Pre-ictal'' refers to the state immediately before the actual seizure, stroke, or headache. * ''Post-ictal'' refers to the state shortly after th ...
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Epileptic Seizure
A seizure is a sudden, brief disruption of brain activity caused by abnormal, excessive, or synchronous neuronal firing. Depending on the regions of the brain involved, seizures can lead to changes in movement, sensation, behavior, awareness, or consciousness. Symptoms vary widely. Some seizures involve subtle changes, such as brief lapses in attention or awareness (as seen in absence seizures), while others cause generalized convulsions with loss of consciousness ( tonic–clonic seizures). Most seizures last less than two minutes and are followed by a postictal period of confusion, fatigue, or other symptoms. A seizure lasting longer than five minutes is a medical emergency known as status epilepticus. Seizures are classified as provoked, when triggered by a known cause such as fever, head trauma, or metabolic imbalance, or unprovoked, when no immediate trigger is identified. Recurrent unprovoked seizures define the neurological condition epilepsy. Clinical features Seizure ...
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Ictal Tachycardia
The postictal state is the altered state of consciousness after an epileptic seizure. It usually lasts between 5 and 30 minutes, but sometimes longer in the case of larger or more severe seizures, and is characterized by drowsiness, confusion, nausea, hypertension, headache or migraine, and other disorienting symptoms. The ictal period is the seizure itself; the interictal period is the time between seizures, when brain activity is more normal; and the preictal period is the time leading up to a seizure: * ''Ictal period'' refers to a physiologic state or event such as a seizure, stroke, or headache. The word originates from the Latin word ''ictus'', meaning a blow or a stroke. In electroencephalography (EEG), the recording during a seizure is said to be "ictal". The following definitions refer to the temporal relation with seizures. * ''Pre-ictal'' refers to the state immediately before the actual seizure, stroke, or headache. * ''Post-ictal'' refers to the state shortly after the ...
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Ictal Asystole
Ictal asystole (IA) is a rare occurrence for patients that have temporal lobe epilepsy. It can often be identified by loss of muscle tone or the presence of bilateral asymmetric jerky limb movements and the lack of heart activity during a seizure, although ECG monitoring is necessary to provide a firm result. Ictal asystole and ictal bradycardia can cause an epileptic patient to die suddenly. Signs and symptoms Ictal asystole is a rare condition and is more common to show up than other heart issues like ictal atrioventricular block and IB. Ictal asystole can cause higher risks of sudden falls, severe injuries and being unresponsive. Most cases have stated that the temporal lobe or insular epilepsy in the brain can affect the heart and this causes the heart to slow down or stop completely. Causes The causes of ictal asystole are associated with temporal and frontal lobe seizures. During a seizure, the brain activity can react in a way that affects the heart rate to slow down o ...
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Sudden Unexpected Death In Epilepsy
Sudden Unexpected Death in Epilepsy (SUDEP) refers to the sudden, unexpected death of a person with epilepsy that is not the result of trauma, drowning, or an identified medical condition. In most cases, no structural or toxicological cause of death is found at autopsy. SUDEP can occur with or without evidence of a preceding seizure, and is often unwitnessed, especially during sleep. The exact mechanisms underlying SUDEP remain unclear but are believed to be multifactorial. Potential contributors include seizure-related disruptions in breathing, heart rhythm, or brain function, often in combination. SUDEP is estimated to affect approximately 1 in 1,000 adults and 1 in 4,500 children with epilepsy each year. It accounts for 7% to 17% of epilepsy-related deaths overall, and up to 50% in those with refractory epilepsy. Deaths caused by status epilepticus or accidents such as drowning are classified separately. Definition To improve consistency in clinical reporting and resear ...
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Electroencephalograph
Electroencephalography (EEG) is a method to record an electrogram of the spontaneous electrical activity of the brain. The bio signals detected by EEG have been shown to represent the postsynaptic potentials of pyramidal neurons in the neocortex and allocortex. It is typically non-invasive, with the EEG electrodes placed along the scalp (commonly called "scalp EEG") using the International 10–20 system, or variations of it. Electrocorticography, involving surgical placement of electrodes, is sometimes called "intracranial EEG". Clinical interpretation of EEG recordings is most often performed by visual inspection of the tracing or quantitative EEG analysis. Voltage fluctuations measured by the EEG bio amplifier and electrodes allow the evaluation of normal brain activity. As the electrical activity monitored by EEG originates in neurons in the underlying brain tissue, the recordings made by the electrodes on the surface of the scalp vary in accordance with their orie ...
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Electrocardiograms
Electrocardiography is the process of producing an electrocardiogram (ECG or EKG), a recording of the heart's electrical activity through repeated cardiac cycles. It is an electrogram of the heart which is a graph of voltage versus time of the electrical activity of the heart using electrodes placed on the skin. These electrodes detect the small electrical changes that are a consequence of cardiac muscle depolarization followed by repolarization during each cardiac cycle (heartbeat). Changes in the normal ECG pattern occur in numerous cardiac abnormalities, including: * Cardiac rhythm disturbances, such as atrial fibrillation and ventricular tachycardia; * Inadequate coronary artery blood flow, such as myocardial ischemia and myocardial infarction; * and electrolyte disturbances, such as hypokalemia. Traditionally, "ECG" usually means a 12-lead ECG taken while lying down as discussed below. However, other devices can record the electrical activity of the heart suc ...
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Cardiac Arrhythmia
Arrhythmias, also known as cardiac arrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. Essentially, this is anything but normal sinus rhythm. A resting heart rate that is too fast – above 100 beats per minute in adults – is called tachycardia, and a resting heart rate that is too slow – below 60 beats per minute – is called bradycardia. Some types of arrhythmias have no symptoms. Symptoms, when present, may include palpitations or feeling a pause between heartbeats. In more serious cases, there may be lightheadedness, passing out, shortness of breath, chest pain, or decreased level of consciousness. While most cases of arrhythmia are not serious, some predispose a person to complications such as stroke or heart failure. Others may result in sudden death. Arrhythmias are often categorized into four groups: extra beats, supraventricular tachycardias, ventricular arrhythmias and bradyarrhythmias. Extra beats incl ...
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