The incidence and significance of periictal apnea in epileptic seizures.

Authors

• Nuria Lacuey
• Bilal Zonjy
• Johnson P Hampson
• M R Sandhya Rani
• Anita Zaremba
• Rup K Sainju
• Brian K Gehlbach
• Stephan Schuele
• Daniel Friedman
• Orrin Devinsky
• Maromi Nei
• Ronald M Harper
• Luke Allen
• Beate Diehl
• John J Millichap
• Lisa Bateman
• Mark A Granner
• Deidre N Dragon
• George B Richerson
• Samden D Lhatoo

Publication/Presentation Date

3-1-2018

Abstract

OBJECTIVE: The aim of this study was to investigate periictal central apnea as a seizure semiological feature, its localizing value, and possible relationship with sudden unexpected death in epilepsy (SUDEP) pathomechanisms.

METHODS: We prospectively studied polygraphic physiological responses, including inductance plethysmography, peripheral capillary oxygen saturation (SpO

RESULTS: Complete datasets were available in 126 patients in 312 seizures. Ictal central apnea (ICA) occurred exclusively in focal epilepsy (51/109 patients [47%] and 103/312 seizures [36.5%]) (P <  .001). ICA was the only clinical manifestation in 16/103 (16.5%) seizures, and preceded EEG seizure onset by 8 ± 4.9 s, in 56/103 (54.3%) seizures. ICA ≥60 s was associated with severe hypoxemia (SpO

SIGNIFICANCE: ICA is a frequent, self-limiting semiological feature of focal epilepsy, often starting before surface EEG onset, and may be the only clinical manifestation of focal seizures. However, prolonged ICA (≥60 s) is associated with severe hypoxemia and may be a potential SUDEP biomarker. ICA is more frequently seen in temporal than extratemporal seizures, and in typical temporal seizure semiologies. ICA rarely persists after seizure end. ICA agnosia is typical, and thus it may remain unrecognized without polygraphic measurements that include breathing parameters.

Volume

59

Issue

3

First Page

573

Last Page

582

ISSN

1528-1167

Published In/Presented At

Lacuey, N., Zonjy, B., Hampson, J. P., Rani, M. R. S., Zaremba, A., Sainju, R. K., Gehlbach, B. K., Schuele, S., Friedman, D., Devinsky, O., Nei, M., Harper, R. M., Allen, L., Diehl, B., Millichap, J. J., Bateman, L., Granner, M. A., Dragon, D. N., Richerson, G. B., & Lhatoo, S. D. (2018). The incidence and significance of periictal apnea in epileptic seizures. Epilepsia, 59(3), 573–582. https://doi.org/10.1111/epi.14006

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

29336036

Department(s)

Administration and Leadership

Document Type

Article