Oxygen desaturations triggered by partial seizures: implications for cardiopulmonary instability in epilepsy

PURPOSE: The occurrence of hypoxemia in adults with partial seizures has not been systematically explored. Our aim was to study in detail the temporal dynamics of this specific type of ictal-associated hypoxemia. METHODS: During long-term video/EEG monitoring (LTM), patients underwent monitoring of...

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Bibliographic Details
Published in:Epilepsia (Copenhagen) 2000-05, Vol.41 (5), p.536-541
Main Authors: Blum, A. S., Ives, J. R., Goldberger, A. L., Al-Aweel, I. C., Krishnamurthy, K. B., Drislane, F. W., Schomer, D. L.
Format: Article
Language:English
Subjects:
Adult
Animals
Autonomic nervous system
Autonomic Nervous System Diseases - etiology
Autonomic Nervous System Diseases - physiopathology
Biological and medical sciences
Cricetinae
Death, Sudden - etiology
Electrocardiography
Electroencephalography
Epilepsies, Partial - blood
Epilepsies, Partial - metabolism
Epilepsies, Partial - physiopathology
Epilepsy, Temporal Lobe - blood
Epilepsy, Temporal Lobe - metabolism
Epilepsy, Temporal Lobe - physiopathology
Female
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Hypoxemia
Hypoxia - blood
Hypoxia - metabolism
Hypoxia - physiopathology
Life Sciences (General)
Male
Medical sciences
Middle Aged
Monitoring, Physiologic
Nervous system (semeiology, syndromes)
Neurology
Oximetry
Oxygen - blood
Oxygen - metabolism
Oxygen desaturation
Partial epilepsy
Respiration Disorders - etiology
Respiration Disorders - physiopathology
Space life sciences
Sudden death
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Summary:PURPOSE: The occurrence of hypoxemia in adults with partial seizures has not been systematically explored. Our aim was to study in detail the temporal dynamics of this specific type of ictal-associated hypoxemia. METHODS: During long-term video/EEG monitoring (LTM), patients underwent monitoring of oxygen saturation using a digital Spo2 (pulse oximeter) transducer. Six patients (nine seizures) were identified with oxygen desaturations after the onset of partial seizure activity. RESULTS: Complex partial seizures originated from both left and right temporal lobes. Mean seizure duration (+/-SD) was 73 +/- 18 s. Mean Spo2 desaturation duration was 76 +/- 19 s. The onset of oxygen desaturation followed seizure onset with a mean delay of 43 +/- 16 s. Mean (+/-SD) Spo2 nadir was 83 +/- 5% (range, 77-91%), occurring an average of 35 +/- 12 s after the onset of the desaturation. One seizure was associated with prolonged and recurrent Spo2 desaturations. CONCLUSIONS: Partial seizures may be associated with prominent oxygen desaturations. The comparable duration of each seizure and its subsequent desaturation suggests a close mechanistic (possibly causal) relation. Spo2 monitoring provides an added means for seizure detection that may increase LTM yield. These observations also raise the possibility that ictal ventilatory dysfunction could play a role in certain cases of sudden unexpected death in epilepsy in adults with partial seizures.
ISSN:0013-9580
1528-1167
DOI:10.1111/j.1528-1157.2000.tb00206.x