Central pontine myelinolysis with complete recovery.
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Adult↗
Biomedical subjects
M J Keilson
Publications and source records attributed to M J Keilson.
Apneic oxygenation in apnea tests.
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Animals↗
Electrocardiographic changes during electrographic seizures.
The occurrence of high-risk cardiac arrhythmias during electrographic seizures has been proposed as a possible cause for sudden unexpected death in patients with epilepsy. Several anecdotal case reports have documented various cardiac irregularities during seizures. We reviewed simultaneous 24-hour electroencephalographic - electrocardiographic studies obtained by ambulatory cassette electroencephalography in 45 patients who experienced 106 electrographic seizures. An increase in heart rate was seen in 96% of seizures, while in four seizures, the rate was unchanged. Heart rate increase measured from 1 minute preictally to intraictal peak ranged from 0% to 160% (mean, 60%). The onset of tachycardia was usually within several seconds (before or after) of the seizure onset, and often persisted for several minutes after termination of the discharge. No difference was found in patients with lateralized vs generalized seizures. Neither ventricular ectopia, conduction defects, or bradycardia were observed during the ictal episodes. We conclude that ictal tachycardia is the rule during electrographic seizures, and that high-risk cardiac arrhythmias are uncommon.
Adolescent↗
ECG abnormalities in patients with epilepsy.
Some investigators believe that patients with epilepsy are at increased risk of sudden death, perhaps because of cardiac arrhythmias. We studied 338 patients with epilepsy referred for simultaneous ambulatory EEG/ECG monitoring. High-risk cardiac arrhythmias were detected in 18 (5.3%) patients while low-risk arrhythmias or negative studies were found in the others. Fifty-six electrographic seizures were seen in 17 patients, but no associated ventricular arrhythmias or conduction defects were identified. We conclude that the incidence of serious cardiac arrhythmias predisposing to sudden death is not increased in patients with epilepsy.
Arrhythmias, Cardiac↗
Ambulatory cassette EEG in absence epilepsy.
Absence epilepsy is associated with bursts of generalized 3 Hz spike-and-wave activity. Even very brief bursts may cause an alteration in the level of consciousness and impaired reaction time. We studied 15 patients, ages 5-16 years, with absence epilepsy using 8 channel ambulatory cassette electroencephalography. All patients demonstrated multiple paroxysms of generalized spike-and-wave discharges, most of which were asymptomatic. Because patients with absence epilepsy may not accurately report seizure frequency, periodic long-term monitoring may be required which is accomplished easily on an outpatient basis with ambulatory cassette electroencephalography.
Adolescent↗