Retrospective Case-Control Study of Ictal Asystole
Research type
Research Study
Full title
Retrospective Case-Control Study of Ictal Asystole of Cases Identified in Epilepsy EEG Video Monitoring Units
IRAS ID
199596
Contact name
R&D Office
Contact email
Sponsor organisation
IDEE
Duration of Study in the UK
2 years, 9 months, 1 days
Research summary
People with epilepsy, especially with uncontrolled generalized tonic-clonic seizures, are at risk of sudden death without a structural cause for death found at autopsy (SUDEP). Their vital functions (breathing/heart) are affected with terminal consequences if seizures are severe.
In a minority of epileptic seizures, the heart stops transiently. With ‘ictal asystole’ (IA) (ictus= seizure; asysole = heart stopping), an epileptic seizure begins then the person collapses as the heart stops. The heart usually restarts soon after with recovery. Although well recognized there are no large series of cases with IA. Much remains unknown in relation to characteristics of those affected, the underlying epilepsy and seizure types. It remains unclear, if people with IA are at greater risk of SUDEP than those without nor how often a permanent pacemaker, which carries its own risks, is needed or implanted.
In a previous international study (MORTEMUS), we identified 96 IA cases from many epilepsy monitoring units. Building on this, we will describe ~100 IA cases compared to a control group from the same epilepsy monitoring units.
Our aims are to:
- describe ~100 IA cases including management and outcome (epilepsy surgery, mortality)
- establish how often a permanent pacemaker is implanted in IA and complications thereof
- compare clinical characteristics and underlying focus for epilepsy of patients with IA compared to controls
- calculate Standardized Mortality Ratios (SMR) and SUDEP incidence in the IA group, paced or otherwise, and the control group
Our secondary aims are to:
- analyze available ECG/EEG traces
- for each patient compare recorded seizures with and without IA
- perform preliminary assessment of mortality in the different groups thus informing the duration of additional follow up needed to find out if IA carries an increased risk of SUDEP compared to controls and if pacing protects against this.
REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
17/LO/0294
Date of REC Opinion
9 May 2017
REC opinion
Further Information Favourable Opinion