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The author cautions that inferring a cause-and-effect relationship between left temporal lobe epileptic activity and cardiac arrhythmias based on 17 reported patients is hazardous.
This letter highlights the potential confounding role of sleep apnea when evaluating cardiac asystole and bradycardia in patients with left temporal lobe complex partial seizures.
Letters18 January 2000Cardiac Asystole and Bradycardia as a Manifestation of Left Temporal Lobe Complex Partial SeizureMichael D. Weinstein, MD and Claude Albertario, RPSGTMichael D. Weinstein, MDWinthrop-University Hospital; Mineola, NY 11501 (Weinstein)Winthrop-University Hospital; Mineola, NY 11501 (Albertario)Search for more papers by this author and Claude Albertario, RPSGTWinthrop-University Hospital; Mineola, NY 11501 (Weinstein)Winthrop-University Hospital; Mineola, NY 11501 (Albertario)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-2-200001180-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In the fascinating report by Locatelli and colleagues (1), the authors conjecture a possible association between left temporal lobe epileptic activity and cardiac asystole or bradycardia. The authors cite their own experience with 3 patients, as well as a review of the literature constituting 10 reports on 14 patients, all of whom underwent simultaneous video electroencephalography-electrocardiography. I would submit, however, that the leap from cortical stimulation studies, in which a cause-and-effect relation may be apparent, to a complex clinical situation with uncontrolled variables is hazardous. Sinus bradycardia and asystole, for example, are also observed relatively frequently in ...References1. Locatelli ER, Varghese JP, Shuaib A, Potolicchio SJ. Cardiac asystole and bradycardia as a manifestation of left temporal lobe complex partial seizure. Ann Intern Med. 1999;130:581-3. LinkGoogle Scholar2. Tilkian AG, Guilleminault C, Schroeder JS, Lehrman KL, Simmons FB, Dement WC. Sleep-induced apnea syndrome. Prevalence of cardiac arrhythmias and their reversal after tracheostomy. Am J Med. 1977;63:348-58. CrossrefMedlineGoogle Scholar3. Guilleminault C, Connolly SJ, Winkle R. Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome. Am J Cardiol. 1983;52:490-4. CrossrefMedlineGoogle Scholar4. Zwillich C, Devlin T, White D, Douglas N, Weil J, Martin R. Bradycardia during sleep apnea. J Clin Invest. 1982;69:1286-92. CrossrefMedlineGoogle Scholar5. Adlakha A, Shepard JW. Cardiac arrhythmias during normal sleep and in obstructive sleep apnea syndrome. Sleep Medicine Reviews. 1998;2:45-60. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Winthrop-University Hospital; Mineola, NY 11501 (Weinstein)Winthrop-University Hospital; Mineola, NY 11501 (Albertario) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoFeatures and Outcomes of Classic Heat Stroke J. Carlos Ayus and Allen I. Arieff Cardiac Asystole and Bradycardia as a Manifestation of Left Temporal Lobe Complex Partial Seizure Eduardo R. Locatelli , Jacob P. Varghese , Ashfaq Shuaib , and Samuel J. Potolicchio Metrics Cited byEpilepsy, Sleep, and Sleep DisordersSudden Epileptic Death in Experimental Animal ModelsBlockade of inhibitory neurotransmission evoked seizure-like firing of cardiac parasympathetic neurons in brainstem slices of newborn rats: Implications for sudden deaths in patients of epilepsyEpilepsy, Sleep, and Sleep Disorders 18 January 2000Volume 132, Issue 2Page: 165-166KeywordsApneaBradycardiaEpileptic seizuresHeartHypoxiaOxygenRapid eye movementSleepSleep apneaTemporal lobe Issue Published: 18 January 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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Weinstein et al. (2000) conducted a letter in Left temporal lobe complex partial seizure. Left temporal lobe epileptic activity was evaluated on Cardiac asystole or bradycardia. The author cautions that inferring a cause-and-effect relationship between left temporal lobe epileptic activity and cardiac arrhythmias based on 17 reported patients is hazardous.
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