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To the Editor:
Surges et al.1 investigated ictal and postictal cardiac features in patients with temporal lobe epilepsy during complex partial and secondarily generalized tonic-clonic seizures (GTCS).
The authors found enhanced QT shortening and persistent tachycardia after secondarily GTCS, which may prime the heart for fatal malignant arrhythmia. This is a valuable addition to the literature and may demystify sudden unexpected death in epilepsy (SUDEP).
Recently, we admitted a patient in whom inpatient video-EEG was initiated for characterization and focus localization. The patient initiated the event marker on multiple occasions when he was on the verge of passing out. These events were not accompanied by changes on the electrocardiogram (ECG) lead. On the day of discharge, he pushed the button at 4:00 am when experiencing his typical aura. This event was time-locked to a 12-beat run of a broad complex tachycardia (supraventricular arrhythmia). An urgent cardiologic consultation was requested.
All seizures are not accompanied by these profound cardiac rhythm alterations. The degree of …
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