Case Report: Ictal Central Apnea as First and Overlooked Symptom in Temporal Lobe Seizures

Ictal respiratory changes have been mainly described following generalized tonic-clonic seizures and recently considered to be a biomarker to assess the risk of sudden unexplained death in epilepsy (SUDEP). Nonetheless, modification of respiratory pattern can be related also to focal seizures, espec...

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Autores principales:	Elisa Micalizzi, Anna Elisabetta Vaudano, Giada Giovannini, Giulia Turchi, Leandra Giunta, Stefano Meletti
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	amygdala temporal lobe epilepsy seizures SUDEP ictal apnea Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/b389468966f1468496fd05fa56d58b19
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spelling	oai:doaj.org-article:b389468966f1468496fd05fa56d58b192021-11-04T05:55:19ZCase Report: Ictal Central Apnea as First and Overlooked Symptom in Temporal Lobe Seizures1664-229510.3389/fneur.2021.753860https://doaj.org/article/b389468966f1468496fd05fa56d58b192021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.753860/fullhttps://doaj.org/toc/1664-2295Ictal respiratory changes have been mainly described following generalized tonic-clonic seizures and recently considered to be a biomarker to assess the risk of sudden unexplained death in epilepsy (SUDEP). Nonetheless, modification of respiratory pattern can be related also to focal seizures, especially arising from the temporal lobe. Changes in cardiac function such as tachycardia or bradycardia could be often associated. We report a short case series of four patients with temporal lobe epilepsy admitted to our Epilepsy Monitoring Unit (EMU) presenting with an ictal central apnea as the first clinical manifestation of their seizures. None of these patients was aware of the occurrence of respiratory arrest. Age at onset ranged from 15 to 29 years. One patient had seizures with prolonged central apnea accompanied by a significant decrease in oxygen saturation. Neuroimaging in two patients showed alterations of mesial temporal lobe structures, including the amygdala. Recent neurophysiological studies supported the existence of a cortical network involving the limbic system that modulates downstream brainstem respiratory centers. Monitoring for respiratory changes and oxygen saturation in focal seizures is warranted for their potential value in identifying the epileptogenic zone and for a better understanding of ictal respiratory changes that could potentially define a subgroup of patients with high risk of seizure-related autonomic changes.Elisa MicalizziAnna Elisabetta VaudanoGiada GiovanniniGiada GiovanniniGiada GiovanniniGiulia TurchiLeandra GiuntaStefano MelettiStefano MelettiFrontiers Media S.A.articleamygdalatemporal lobe epilepsyseizuresSUDEPictal apneaNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	amygdala temporal lobe epilepsy seizures SUDEP ictal apnea Neurology. Diseases of the nervous system RC346-429
spellingShingle	amygdala temporal lobe epilepsy seizures SUDEP ictal apnea Neurology. Diseases of the nervous system RC346-429 Elisa Micalizzi Anna Elisabetta Vaudano Giada Giovannini Giada Giovannini Giada Giovannini Giulia Turchi Leandra Giunta Stefano Meletti Stefano Meletti Case Report: Ictal Central Apnea as First and Overlooked Symptom in Temporal Lobe Seizures
description	Ictal respiratory changes have been mainly described following generalized tonic-clonic seizures and recently considered to be a biomarker to assess the risk of sudden unexplained death in epilepsy (SUDEP). Nonetheless, modification of respiratory pattern can be related also to focal seizures, especially arising from the temporal lobe. Changes in cardiac function such as tachycardia or bradycardia could be often associated. We report a short case series of four patients with temporal lobe epilepsy admitted to our Epilepsy Monitoring Unit (EMU) presenting with an ictal central apnea as the first clinical manifestation of their seizures. None of these patients was aware of the occurrence of respiratory arrest. Age at onset ranged from 15 to 29 years. One patient had seizures with prolonged central apnea accompanied by a significant decrease in oxygen saturation. Neuroimaging in two patients showed alterations of mesial temporal lobe structures, including the amygdala. Recent neurophysiological studies supported the existence of a cortical network involving the limbic system that modulates downstream brainstem respiratory centers. Monitoring for respiratory changes and oxygen saturation in focal seizures is warranted for their potential value in identifying the epileptogenic zone and for a better understanding of ictal respiratory changes that could potentially define a subgroup of patients with high risk of seizure-related autonomic changes.
format	article
author	Elisa Micalizzi Anna Elisabetta Vaudano Giada Giovannini Giada Giovannini Giada Giovannini Giulia Turchi Leandra Giunta Stefano Meletti Stefano Meletti
author_facet	Elisa Micalizzi Anna Elisabetta Vaudano Giada Giovannini Giada Giovannini Giada Giovannini Giulia Turchi Leandra Giunta Stefano Meletti Stefano Meletti
author_sort	Elisa Micalizzi
title	Case Report: Ictal Central Apnea as First and Overlooked Symptom in Temporal Lobe Seizures
title_short	Case Report: Ictal Central Apnea as First and Overlooked Symptom in Temporal Lobe Seizures
title_full	Case Report: Ictal Central Apnea as First and Overlooked Symptom in Temporal Lobe Seizures
title_fullStr	Case Report: Ictal Central Apnea as First and Overlooked Symptom in Temporal Lobe Seizures
title_full_unstemmed	Case Report: Ictal Central Apnea as First and Overlooked Symptom in Temporal Lobe Seizures
title_sort	case report: ictal central apnea as first and overlooked symptom in temporal lobe seizures
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/b389468966f1468496fd05fa56d58b19
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Case Report: Ictal Central Apnea as First and Overlooked Symptom in Temporal Lobe Seizures

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