Generalized tonic-clonic seizures detected by implantable loop recorder devices: diagnosing more than cardiac arrhythmias.
Publication/Presentation Date
7-1-2006
Abstract
BACKGROUND: Both syncope and seizures are important causes of recurrent, unexplained episodes of loss of consciousness. Implantable loop recorders have identified serious arrhythmias in patients with repeated syncope; however, implantable loop recorder detection of seizures is less well established.
OBJECTIVES: The purpose of this study was to provide in-depth analysis of a characteristic myopotential pattern recorded by implantable loop recorders during generalized tonic-clonic seizures.
METHODS: Fourteen patients with refractory, video-EEG-documented epilepsy (complex partial, atonic, tonic, or generalized tonic-clonic seizures) underwent implantable loop recorder placement as part of a study protocol evaluating cardiac rhythm abnormalities in patients at high risk for sudden unexpected death in epilepsy.
RESULTS: Twelve generalized tonic-clonic seizure episodes were detected by the implantable loop recorder in six patients. Implantable loop recorder and EEG recordings of generalized tonic-clonic seizures were identical and revealed a tonic phase (sustained, rapid, high-frequency myopotentials) transitioning to a clonic phase (periodic bursts of high-frequency myopotentials with a decelerating burst frequency from 3-6 Hz to 1-2 Hz) prior to seizure termination. With the nonprogrammable bandpass filter of 0.85 to 32 Hz in the implantable loop recorder, all generalized tonic-clonic seizure episodes had escaped automatic detection and required activation by family members. None of the 76 nongeneralized tonic-clonic seizure episodes recorded on the implantable loop recorder in the 14 patients exhibited the stereotypical tonic-clonic pattern that defines generalized seizures.
CONCLUSION: Recognizing this specific myopotential pattern on an implantable loop recorder might help diagnose generalized tonic-clonic seizures as a cause of recurrent, unexplained episodes of loss of consciousness. Having a programmable bandpass filter in the implantable loop recorder might increase its diagnostic yield for such patients.
Volume
3
Issue
7
First Page
857
Last Page
861
ISSN
1547-5271
Published In/Presented At
Ho, R. T., Wicks, T., Wyeth, D., & Nei, M. (2006). Generalized tonic-clonic seizures detected by implantable loop recorder devices: diagnosing more than cardiac arrhythmias. Heart rhythm, 3(7), 857–861. https://doi.org/10.1016/j.hrthm.2006.03.026
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
16818222
Department(s)
Administration and Leadership
Document Type
Article