[Ictal syncopes. Cardiac sympathetic innervation disorder as the etiology?].

Publication

[Ictal syncopes. Cardiac sympathetic innervation disorder as the etiology?].

Journal Paper/Review - Aug 1, 1998

Von Manitius Sigrid, Schüler P, Feistel H, Platsch G, Stefan Hermann

Citation

Von Manitius S, Schüler P, Feistel H, Platsch G, Stefan H. [Ictal syncopes. Cardiac sympathetic innervation disorder as the etiology?]. Nervenarzt 1998; 69:712-6.

Type

Journal Paper/Review (Deutsch)

Journal

Nervenarzt 1998; 69

Publication Date

Aug 1, 1998

Issn Print

0028-2804

Pages

712-6

Brief description/objective

We report 3 cases of an ictal sinus arrest. All patients suffered from temporal lobe epilepsy (TLE). Seizures were monitored with simultaneous video-eeg during preoperative epilepsy diagnosis. One patient with cortical dysplasia, who frequently suffered from long lasting syncopes, had a nearly completely missing cardiac sympathetic innervation in MIBG-SPECT (=Meta-Iodide-Benzyle-Guanidine-single-photon-emission tomography). Cardiac investigation including long-term ECG and echocardiography had shown normal findings. After epilepsy surgery the syncopal events in all patients disappeared. A dominant parasympathetic ictal stimulus following excitation of the reticular formation might cause the ictal bradycardia and sinus arrest. A missing sympathetic innervation, possibly occurring as fehlbildung together with cortical dysplasia, which makes autoregulation impossible, might then be the explanation for sudden cardiac ictal death.