Asystole induced by electrical stimulation of the left cingulate gyrus

Howan Leung, Kasper Schindler, Patrick Kwan, Christian Elger

Research output: Contribution to journalReview ArticleResearchpeer-review

39 Citations (Scopus)

Abstract

The cortical control of the autonomic system may account for the clinical phenomenon of ictal asystole which, in turn, has been speculated to be a potential mechanism for sudden unexpected death in epilepsy (SUDEP). We report an 18-year-old patient with frontal lobe epilepsy who had intracranial electrode placement showing bifrontal seizure-onset. This patient received electrical stimulation to the left cingulate gyrus and developed cardiac asystole within 3 seconds of electrical stimulation. Intracranial monitoring showed epileptiform discharges in the left frontal polar, frontal lateral and interhemispheric electrodes. We suggest that the left cingulate gyrus, as part of the central autonomic network, may mediate bradyarrhythmia through the vagal pathway. There remains the possibility that other brain regions were also involved due to the time lag between asystole and epileptiform discharges, and the lack of intracranial exploration in the mesial temporal and insular regions.

Original languageEnglish
Pages (from-to)77-81
Number of pages5
JournalEpileptic Disorders
Volume9
Issue number1
DOIs
Publication statusPublished - 1 Mar 2007
Externally publishedYes

Keywords

  • Cardiac asystole
  • Cingulate gyrus
  • Frontal lobe epilepsy
  • SUDEP

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