Ictal sinus pause and myoclonic seizure in a child.
10.3345/kjp.2016.59.11.S129
- Author:
Hye Ryun KIM
1
;
Gun Ha KIM
;
So Hee EUN
;
Baik Lin EUN
;
Jung Hye BYEON
Author Information
1. Department of Pediatrics, Korea University College of Medicine, Seoul, Korea. byeonagnes@naver.com
- Publication Type:Case Report
- Keywords:
Asystole;
Sinus pause;
Electroencephalography
- MeSH:
Adult;
Arrhythmias, Cardiac;
Bradycardia;
Child*;
Child, Preschool;
Echocardiography;
Electrocardiography;
Electroencephalography;
Epilepsy;
Epilepsy, Temporal Lobe;
Female;
Heart Arrest;
Humans;
Myoclonus;
Seizures*;
Tachycardia;
Valproic Acid
- From:Korean Journal of Pediatrics
2016;59(Suppl 1):S129-S132
- CountryRepublic of Korea
- Language:English
-
Abstract:
Ictal tachycardia and bradycardia are common arrhythmias; however, ictal sinus pause and asystole are rare. Ictal arrhythmia is mostly reported in adults with temporal lobe epilepsy. Recently, ictal arrhythmia was recognized as a major warning sign of sudden unexpected death in epilepsy. We present an interesting case of a child with ictal sinus pause and asystole. A 27-month-old girl was hospitalized due to 5 episodes of convulsions during the past 2 days. Results of routine electroencephalography (EEG) were normal, but she experienced brief generalized tonic seizure for 3 days. During video-monitored EEG and echocardiography (ECG), she showed multiple myoclonic seizures simultaneously or independently, as well as frequent sinus pauses. After treatment with valproic acid, myoclonus and generalized tonic seizures were well controlled and only 2 sinus pauses were seen on 24-hour Holter ECG monitoring. Sinus dysfunction should be recognized on EEG, and it can sometimes be treated successfully with only antiepileptic medication.
