围癫痫发作期的心脏呼吸功能障碍的研究

The study of cardiac respiratory dysfunction in peri-epileptic period

目的探讨围癫痫发作期发生的心脏、呼吸功能障碍全程的临床及电生理特点。方法对2016年10月-2022年4月在西京医院神经内科脑电监测中心行长程视频脑电监测的12000名患者进行回顾性分析,将癫痫发作期、发作后发生心脏呼吸功能障碍的癫痫患者作为研究对象,分析其癫痫发作全程的临床和电生理变化,并进行随访。结果在脑电监测期间,3例患者发生5次围癫痫发作期心肺功能障碍。2例女性、1例男性,年龄23~55岁,癫痫病程9~40 y。1例患者发生继发性全身强直阵挛发作(sGTCS)后出现全面EEG抑制(PGES),期间呼吸运动消失,心率低至25次/min,持续74 s;1例患者闪光刺激诱发一次癫痫发作,期间心脏停搏15 s;1例患者2次癫痫发作期间发生心脏停搏,持续时间分别是5 s和3 s。随访时间6 m~7 y,3例患者无癫痫发作。结论心肺功能障碍发生于癫痫发作后的PGES期间、心脏停搏发生于癫痫发作期,也许与癫痫性猝死有关。

Objective To explore the clinical and electrophysiological characteristics of cardiac-respiratory dysfunction during the peri-epileptic seizure period.Methods A retrospective analysis was made from 12000 patients with long-term video electroencephalograph(EEG)monitoring from October 2016 to April 2022 in the Department of Neurology,Xijing Hospital.Epilepsy patients with cardiac and respiratory dysfunction during peri-epileptic seizure period were enrolled,and their clinical and electrophysiological changes during the peri-epileptic seizure period were analyzed.Results Three patients experienced five seizures with cardiopulmonary dysfunctions during the EEG monitoring.Two of them were female and one was male,and their age was from 23 to 55 years old with epilepsy history of 9~40 years.One patient experienced sGTCS(secondly generalized tonic-clonic seizures)followed by generalized EEG suppression(PGES),during which respiratory movements disappeared for 74 s and the heart rate was as low as 25 bpm.One patient experienced ictal asytole lasting for 15 s during a seizure induced by flash stimulation;one patient experienced ictal asytole during two seizures,which lasted for 5 s and 3 s respectively.Follow-up time ranged from 6 months to 7 years,and all the three patients were seizure free.Conclusion Cardiopulmonary dysfunction occurs during PGES after seizures,and ictal asytole occurs during seizures,which maybe related with sudden unexpected death in epilepsy(SUDEP).