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Abstract:
Cardiac arrhythmias are frequently observed during epileptic seizures. Well known are sinus tachycardia, severe bradycardia and asystole. Other abnormalities such as atrial fibrillation, sinus arrhyhtmia, supraventricular tachycardia, artrial or ventricular premature depolarization, bundle branch block and reduced heart rate variability have been reported as well. Especially patients with focal epileptic seizures involving the insula and parts of the frontal and temporal lobe are at risk. It is believed that at least some cases of sudden unexpected death in epilepsy (SUDEP) are caused by cardiac arrhythmia.
However, data on seizure related ventricular tachycardia are rare. To our knowledge there is only one case report in the literature with seizure induced ventricular tachycardia. This patient was in cardiac health.
We report a case of a 59 year-old man with structural epilepsy and focal epileptic seizures after cardioembolic stroke in the gyrus frontalis inferior on the left side, suffering from epileptic seizure related monomorphic ventricular tachycardia. He was first admitted to our clinic with cardioembolic stroke after subacute myocardial infarction, followed by ventricular tachycardia. In the following months he had several focal seizures with accompanying ventricular tachycardia. Treatment strategies included antiepileptic drugs, rhythm stabilizing medication, and finally pacemaker implantation.