Management and outcome in patients with ictal bradycardia and asystole

Purpose: Ictal bradycardia and asystole are rare autonomic symptoms during epileptic seizures and are potentially life-threatening. The pathop-hysiological mechanisms are poorly understood and a potential contribution to SUDEP remains speculative. Guidelines for the care of patients with ictal arrhythmias are missing. However, in order to prevent life-threatening cardiac arrest, syncope and trauma, such patients should be treated actively and individually, once the diagnosis is established. We report on management and outcome of four patients in whom simultaneous EEG/ECG recording showed ictal bradycardia or asy…