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Author Affiliations: Department of Neurology, Rambam Medical Center (Drs Herskovitz and Schiller) and the Technion Medical School (Dr Schiller), Haifa, Israel.
Background Epileptic seizures are often associated with changes in cardiac autonomic function. Yet atrial fibrillation (AFib) or atrial flutter (AFlu) following epileptic seizures has only rarely been reported in the past.
Objectives To describe and characterize patients who experienced lone AFib or AFlu as a consequence of epileptic seizures.
Design Case reports.
Setting University teaching hospital.
Patients We describe 4 patients who developed transient AFib following epileptic seizures and 1 patient who developed transient AFlu following epileptic seizures.
Results In all patients, AFib and AFlu followed a generalized tonic-clonic seizure. The arrhythmia usually lasted a few hours and converted spontaneously to a normal sinus rhythm. In 3 patients, AFib or AFlu developed during the first seizure they experienced, and none of the patients developed drug-resistant epilepsy. Moreover, none of the patients had a known cardiac disease, yet, in 2 patients, the cardiological workup demonstrated mild abnormalities on the cardiac stress test.
Conclusions Atrial fibrillation is the most common type of arrhythmia, with an estimated prevalence of 1%. Despite the fact that AFib can cause syncope, it is important to consider the possibility of AFib developing secondary to an epileptic seizure in cases of AFib and transient loss of consciousness.
Herskovitz M, Schiller Y. Atrial Fibrillation Associated With Epileptic Seizures. Arch Neurol. 2012;69(9):1197–1199. doi:10.1001/archneurol.2011.3647
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