Oxygen desaturations triggered by partial seizures: Implications for cardiopulmonary instability in epilepsy
Oxygen desaturations triggered by partial seizures: Implications for cardiopulmonary instability in epilepsy
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DOI：
10.1111/j.1528-1157.2000.tb00206.x
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发表时间：
2000-05-01
期刊：
影响因子：
5.6
通讯作者：
Schomer, DL
中科院分区：
文献类型：
--
作者：
Blum, AS;Ives, JR;Schomer, DL
目的：成人部分性癫痫发作后低氧血症的发生尚未有系统的研究。我们的目的是详细研究这种特殊类型的发作期相关低氧血症的时间动力学。方法：在长期视频/脑电监测(LTM)期间，患者使用数字Spo(2)(脉搏血氧计)传感器进行血氧饱和度监测。6例患者(9次发作)在部分性发作活动开始后出现氧减饱和度。结果：复杂部分性发作起源于左侧和右侧颞叶。平均发作持续时间(+/-SD)为73+/-18 S，平均Spo(2)减饱和持续时间为76+/-19 S，发作后开始氧减饱和的平均延迟为43+/-16 S，平均(+/-SD)Spo(2)最低点为83+/-5%(范围77-91%)，平均出现35+/-12次S。1例癫痫发作与Spo(2)持续和反复的血氧饱和度降低有关。每次癫痫发作的持续时间和随后的减饱和度表明了一种密切的机械性(可能是因果)关系。SpO(2)监测为癫痫检测提供了一种额外的手段，这可能会增加LTM产量。这些观察还提出了这样一种可能性，即发作性呼吸功能障碍可能在部分发作的成年人癫痫突发意外死亡的某些病例中发挥作用。
Purpose: The occurrence of hypoxemia in adults with partial seizures has not been systematically explored. Our aim was to study in detail the temporal dynamics of this specific type of ictal-associated hypoxemia.Methods: During long-term video/EEG monitoring (LTM), patients underwent monitoring of oxygen saturation using a digital Spo(2) (pulse oximeter) transducer. Six patients (nine seizures) were identified with oxygen desaturations after the onset of partial seizure activity.Results: Complex partial seizures originated from both left and right temporal lobes. Mean seizure duration (+/-SD) was 73 +/- 18 s. Mean Spo(2) desaturation duration was 76 +/- 19 s. The onset of oxygen desaturation followed seizure onset with a mean delay of 43 +/- 16 s. Mean (+/-SD) Spo(2) nadir was 83 +/- 5% (range, 77-91%), occurring an average of 35 +/- 12 s after the onset of the desaturation. One seizure was associated with prolonged and recurrent Spo(2) desaturations.Conclusions: Partial seizures may be associated with prominent oxygen desaturations. The comparable duration of each seizure and its subsequent desaturation suggests a close mechanistic (possibly causal) relation. Spo(2) monitoring provides an added means for seizure detection that may increase LTM yield. These observations also raise the possibility that ictal ventilatory dysfunction could play a role in certain cases of sudden unexpected death in epilepsy in adults with partial seizures.