Postictal bradyarrhythmia following an isolated seizure in a patient with left hemisphere stroke.
Postictal bradyarrhythmia following an isolated seizure in a patient with left hemisphere stroke.
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左半球卒中患者孤立性癫痫发作后出现发作后缓慢性心律失常。
DOI：
10.1016/j.seizure.2013.06.009
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Herman,SusanT
中科院分区：
文献类型：
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作者：
Krishnan,Vaishnav;Tarula,Erick;Anderson,MatthewP;Hanafy,KhalidA;Herman,SusanT
猝死对难治性癫痫和急性中风患者的死亡率有显着影响。 1, 2 目前，我们的领域对这些现象背后的病理生理学只有初步的了解，并且提出的底物包括致命的中枢介导的心律失常。一名 73 岁的糖尿病高血压女性，患有心房颤动（由于最近严重鼻衄，未接受抗凝治疗），因新发口齿不清、流口水和发字困难而到我们急诊室就诊。检查时，她情绪激动，高血压高达 209/132，心房颤动高达 118。她表现出明显的接受性失语，伴构音障碍和右偏偏瘫，以及右侧偏盲和轻度右侧偏瘫。非造影头部计算机断层扫描显示没有出血或明显的低密度。由于症状出现时间未知，溶栓治疗被推迟。她被推测患有左半球栓塞性中风，被送进神经重症监护病房并接受肝素治疗。
Sudden death contributes significantly to mortality in patients with refractory epilepsy and acute stroke. 1, 2 Presently, our field has only a rudimentary understanding of the pathophysiology underlying these phenomena, and proposed substrates include lethal centrally mediated cardiac arrhythmias.A 73-year-old diabetic hypertensive woman with atrial fibrillation (not anticoagulated due to recent severe epistaxis) presented to our emergency ward for new onset slurred speech, drooling and difficulty producing words. On examination, she was agitated, hypertensive to 209/132, and in atrial fibrillation at a rate of 118. She displayed a predominantly receptive aphasia with dysarthria and right hemineglect, as well as right hemianopsia and a mild right hemiparesis. A noncontrast head computed tomography scan showed no hemorrhages or conspicuous hypodensities. Thrombolysis was deferred as the time of onset of symptoms was unknown. Presumed to have a left hemisphere embolic stroke, she was admitted to the neurointensive care unit and heparinized.