Ictal bradycardia is when people with
temporal lobe epilepsy
Temporal lobe epilepsy (TLE) is a chronic disorder of the nervous system which is characterized by recurrent, unprovoked focal seizures that originate in the temporal lobe of the brain and last about one or two minutes. TLE is the most common f ...
experience
bradycardia
Bradycardia (also sinus bradycardia) is a slow resting heart rate, commonly under 60 beats per minute (BPM) as determined by an electrocardiogram. It is considered to be a normal heart rate during sleep, in young and healthy or elderly adults, a ...
with their
seizure
An epileptic seizure, informally known as a seizure, is a period of symptoms due to abnormally excessive or synchronous neuronal activity in the brain. Outward effects vary from uncontrolled shaking movements involving much of the body with los ...
s (epileptic discharges). Bradycardia is defined by a slower than normal
heart rate
Heart rate (or pulse rate) is the frequency of the heartbeat measured by the number of contractions (beats) of the heart per minute (bpm). The heart rate can vary according to the body's physical needs, including the need to absorb oxygen and excr ...
, less than 60 bpm. (Normal range is 60-100 bpm).
Ictal
The postictal state is the altered state of consciousness after an epileptic seizure. It usually lasts between 5 and 30 minutes, but sometimes longer in the case of larger or more severe seizures, and is characterized by drowsiness, confusion, nau ...
epileptic discharges can effect changes in cardiac rhythm. An increase in heart rhythm is common during
seizures
An epileptic seizure, informally known as a seizure, is a period of symptoms due to abnormally excessive or neural oscillation, synchronous neuronal activity in the brain. Outward effects vary from uncontrolled shaking movements involving much o ...
. This type of epileptic seizure is known as
ictal tachycardia, in which the subject's heart rate increase of more than 10 beats per minute of above the baseline. In comparison, ictal bradycardia causes epileptic discharges that disrupt the normal cardiac rhythm in a negative fashion. Slowing the heart beat down by more than 10 beats per minute below the average baseline.
Ictal bradycardia is a potential cause or reason for
ictal asystole Ictal asystole is a rare occurrence for patients that have temporal lobe epilepsy. It can often be identified by loss of muscle tone or the presence of bilateral asymmetric jerky limb movements during a seizure, although ECG
Electrocardiograph ...
to occur and is believed to help explain the phenomenon of
sudden unexpected death in epilepsy
Sudden unexpected death in epilepsy (SUDEP) is a fatal complication of epilepsy. It is defined as the sudden and unexpected, non-traumatic and non-drowning death of a person with epilepsy, without a toxicological or anatomical cause of death det ...
(SUDEP).Through the simultaneous use of
electroencephalograph (EEG) and
electrocardiograms
Electrocardiography is the process of producing an electrocardiogram (ECG or EKG), a recording of the heart's electrical activity. It is an electrogram of the heart which is a graph of voltage versus time of the electrical activity of the hear ...
(ECG), researchers can monitor and record a patient going through ictal bradycardia seizures. And most importantly provide treatment with both antiepileptic drugs and cardiac pace as deemed necessary for the patient. Although there is limited amount of information about ictal bradycardia, as it is a relatively new discovery and is considered to be rare condition, researchers suggest that early diagnosis and treatment of ictal bradycardia can eliminate the chances of sudden unexpected death in epilepsy.
References
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Cardiac arrhythmia
Epilepsy types