The importance of cardiac monitoring in the epilepsy monitoring unit: A case presentation of ictal asystole

Susan D. Agostini, Ejerzain Aniles, Joseph Sirven, Joseph F. Drazkowski

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Ictal asystole may be a potent marker for epilepsy patients at high risk for sudden unexpected death in epilepsy (SUDEP). The use of inpatient long-term video-electroencephalographic (VEEG) monitoring coupled with simultaneous continuous cardiac telemetry is an important tool to detect ictal asystole as well as other significant ictal cardiac arrhythmias. In this paper a case of ictal asystole detected during VEEG is presented. Routine 12-lead EKG was normal upon admission. After antiepileptic medication was tapered, the patient had a typical complex partial seizure with oral automatisms at onset followed by secondary generalization. Ictal onset was noted in left temporal lobe with subsequent spread to the right temporal region. A 20 second period of asystole began just prior to the secondary generalization. During this admission the patient underwent a potentially life-saving pacemaker implantation. The use of cardiac telemetry and baseline EKG are suggested for patients admitted into epilepsy monitoring units as part of the standard epilepsy monitoring protocol.

Original languageEnglish (US)
Pages (from-to)250-260
Number of pages11
JournalNeurodiagnostic Journal
Issue number3
StatePublished - Sep 1 2012


  • Cardiac telemetry
  • Electrocardiogram (ekg)
  • Epilepsy monitoring unit (emu)
  • Ictal asystole (ia)
  • Sudden unexpected death in epilepsy (sudep)
  • Temporal lobe epilepsy

ASJC Scopus subject areas

  • Clinical Neurology
  • Medical Laboratory Technology


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