• World Neurosurg · Dec 2018

    Ictal asystole induced by right posterior quadrant epilepsy - report of a radically treated case.

    • Naoki Ichikawa, Ayataka Fujimoto, Tohru Okanishi, Keishiro Sato, Shimpei Baba, Shinji Itamura, Mitsuyo Nishimura, and Hideo Enoki.
    • Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Shizuoka, Japan.
    • World Neurosurg. 2018 Dec 1; 120: 337-342.

    BackgroundIctal asystole (IA) and ictal bradycardia (IB) are mainly seen with temporal or frontal lobe epilepsy. Many patients with these conditions undergo cardiac pacemaker therapy but not epilepsy surgery.Case DescriptionWe report the case of a 15-year-old boy with IA and IB secondary to right posterior quadrant epilepsy (PoQE) who underwent right posterior quadrant disconnection, but not cardiac pacemaker implantation. He has remained free from daily epileptic seizures, IA, and IB for more than 6 months postoperatively. This is the first report of a radically treated case with IA and IB caused by PoQE.ConclusionsBoth temporofrontal lobe epilepsy and PoQE caused the IA and IB. Because a cardiac pacemaker only addresses arrhythmia, not epileptic seizures, radical treatment for both epilepsy and arrhythmia may be warranted for patients with medically intractable epilepsy.Copyright © 2018 Elsevier Inc. All rights reserved.

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