Role Of The Screening Ecg In People With Epilepsy
Epilepsy News From: Monday, June 13, 2016
Many studies have shown that people with epilepsy are at higher risk for sudden death than the general population. Many of these unexpected deaths are SUDEP but people with epilepsy may also be susceptible to sudden cardiac death and myocardial infarction .
Could some of these at-risk people be identified with a routine screening, 12-lead electrocardiogram ?
Can A Seizure Cause A Heart Attack
The most common type of seizure is known as a generalized tonic-clonic seizure . This is when you lose consciousness for more than five minutes, have convulsions and fall to the ground.
You may also experience muscle contractions called myoclonus. During this time, your heart rate will increase, and blood pressure will drop.
Rethinking Seizures Associated With Cardiac Disease
Fly study suggests neuronal gene malfunction, not oxygen deprivation, is behind long QT seizures
Most people with a medical condition called long QT syndrome have a mutation in a gene that causes bouts of fast, chaotic heartbeats. They also experience fainting spells and seizures. The clinical approach has largely assumed that when the heart beats erratically, the brain eventually does not get enough oxygen which in turn causes the seizures.
Research from Washington University in St. Louis finds that mutations of a gene implicated in long QT syndrome in humans may trigger seizures because of their direct effects on certain classes of neurons in the brain independent from what the genetic mutations do to heart function. The new work from Arts & Sciences was conducted with fruit flies and is published Aug. 8 in PLOS Genetics.
This gene seems to be a key factor in the physiological process that protects neurons from starting to fire uncontrollably in response to a rapid increase in temperature, which could lead to paralysis and death, said Yehuda Ben-Shahar, associate professor of biology in Arts & Sciences.
Alexis Hill, recently a postdoctoral fellow in the Ben-Shahar laboratory, discovered this unexpected relationship as she probed the nervous system response to acute environmental stress.
The ability of flies to resist the heat is in neurons that release neurotransmitters that make other neurons fire faster, the ones that excite neurons, Ben-Shahar said.
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What Causes Dissociative Seizures
We all react to frightening or stressful situations differently. When we are frightened we might feel physical symptoms such as a racing heartbeat or a sweaty feeling. When we feel sad, we might cry. So how we feel emotionally can sometimes cause a physical reaction.
An extremely frightening or upsetting experience may be so emotionally difficult for some people to think about that they cannot consciously cope with how this makes them feel.
In some cases, we will unconsciously hide or repress the memory of these experiences. These memories may always remain hidden and we may never remember the events that have happened.
For some people, the memories of these painful past events can suddenly come up or intrude into their thoughts or awareness. This might happen during an emotional or stressful situation or when there is something in the environment that unconsciously triggers a distressing memory.
Dissociative seizures can happen as a cut-off mechanism to prevent bad memories being relived. The person splits off from their feelings about the experience because it is too difficult to cope with. The seizure happens because their emotional reaction causes a physical effect.
These seizures are an unconscious reaction so they are not deliberate and the person has no control over them.
- major accidents
Sudden Cardiac Arrest: An Electrical Problem
The Person is Not Awake and the Heart is Not Beating
Sudden cardiac arrest is different from heart attack. While heart attack is described as a plumbing problem, SCA is more of an electrical problem that prevents the heart from functioning effectively. Heart attack can lead to SCA, but there are many other causes, such as congenital abnormalities, severe heart failure, electrocution and drug overdose.
Signs and Symptoms
When SCA occurs, the heart stops beating altogether. As a result, blood no longer is pumped throughout the body, including the brain. The person suddenly passes out, loses consciousness, and appears lifelessexcept for abnormal gasping which may last for several minutes.
Occasionally, SCA victims will experience 10-20 seconds of seizure activity at the onset of the event as the brain stops receiving blood and oxygen from the heart.
The SCA victim is never awake and needs immediate help. If nothing is done, the victim will die within minutes.
When SCA occurs, it is critically important that whoever is near the victim calls 9-1-1 immediately, checks for signs of life, and if there are none, gives CPR and uses the nearest automated external defibrillator .
This is lifesaving care that any layperson can provide. It is best to be trained in CPR and the use of AEDs, but even without formal training, the rescuer can push hard and fast on the victims chest and follow the directions on the AED, while waiting for EMS to arrive.
What to do:
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What Are The Different Kinds Of Strokes And Seizures
Dr. Shlee Song : More than 80% of strokes are ischemic, which is when a blood clot or a chunk of plaque travels to the brain. In hemorrhagic strokes, an artery in the brain bursts, causing blood to spill into surrounding tissue. In both cases, the result is a loss of blood supply in parts of the brain.
Dr. Lisa Bateman : Seizures are also divided into two main types: Focal seizures happen in one side of the brain, while generalized seizures involve both sides at once. Epilepsy is a tendency to have repeated seizures.
For seizures as well as strokes, symptoms can include signs that are not well-known at all, so it’s important to know the range of things to look for.
Keep A Normal Routine If Possible
For some people, NES may disrupt their daily life or they may want to avoid acitivities in case they have a seizure. However, studies show that it can help to keep as normal a routine as possible, and to try to take part in activities with other people. This may help to avoid becoming isolated and anxious, which may make seizures more likely.
Treatment for NES may work best when someone is active in life, including working, studying, or taking part in other activities which are meaningful and satisfying.
If you are working, your employer has a responsibility to keep you and other employees safe at work. To do this, they may need to know about any medical conditions that affect you at work, including NES.
Your employer may need to do a risk assessment to see if your condition may affect safety at work.
See our information on employment.
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Can Panic Attacks Cause Seizures
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Is It Safe To Become Pregnant If I Have Epilepsy And Take Medication
People with epilepsy can have children. While many anti-epilepsy medications arent considered safe during pregnancy, most people with epilepsy can still have healthy children by working with a healthcare provider. Your healthcare provider is the best person to talk to guide you on this or refer you to a specialist.
A note from Cleveland Clinic
Seizures are not an uncommon neurological condition. About 11% of people will have a seizure at some point in their life, but most will have only one, and its often for a specific reason. That means the one seizure wont ever be a problem again. People who have more than one seizure without a specific underlying reason have epilepsy. While epilepsy is often a frightening condition, there are ways to treat it. With treatment, many people with epilepsy can live happy, fulfilling lives.
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Who Does It Affect
Everyone can have seizures, but some people have medical conditions that make them happen more easily. Seizures are also more likely at certain ages. Children are more likely to have seizures and epilepsy, but many grow out of the condition. The risk of having a seizure or developing epilepsy also starts rising at age 50 because of conditions like stroke.
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Anxiety Is Not Always Mental
The most important thing to understand is that anxiety is not just a problem with the way you think. It also affects the way you feel. It can cause chain reactions that lead to symptoms so pronounced they feel like you are suffering from a stroke.
The key thing to understand is that the symptoms can be so similar that you should still strongly consider seeing a doctor. Only a doctor can provide you with a diagnosis, and when it comes to your health there is nothing you should leave to chance.
But the symptoms of anxiety are very real, and many of them resemble a stroke-like experience, for example:
- Difficulty thinking or formulating thoughts.
- Feeling like limbs or muscles cannot move.
- Blurry vision or dizziness.
- Sudden feeling of doom.
Those are âbrain symptomsâ that could occur in a stroke. There are also heart symptoms that may cause someone to feel like they are having a heart attack. Heart attacks and strokes are very different, but moments of pure fear it may feel like theyâre one in the same.
These symptoms are very scary, especially for those that have never had an anxiety attack before. In some cases for a while after the problem occurs it may feel like the symptoms donât recover right away, leading many to convince themselves theyâve had a stroke.
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Cardiac Autonomic Data In Epilepsy
Several studies have documented abnormalities in cardiac autonomic status during the interictal state of epilepsy. Assessments of heart rate and blood pressure during deep breathing and the Valsalva maneuver suggest that the function of the parasympathetic and sympathetic nervous systems, which mediate these responses, are diminished among patients with epilepsy, as compared with a control population . In a subsequent study, Ansakorpi and colleagues evaluated similar testing and found that patients with refractory temporal lobe epilepsy appear to have greater dysfunction of cardiovascular autonomic regulation than those with well-controlled temporal lobe epilepsy .
Anxiety And Seizures: Heres What You Need To Know
It is very common for people with epilepsy to experience anxiety. Find out about anxiety and seizures, diagnosis and ideas for coping.
Anxiety is a perfectly normal response to a stressful situation, and it often goes away when the problem has passed. People can sometimes feel excessively anxious even when there is no obvious danger. This is known as an anxiety disorder.
Anxiety disorders are the most common mental health issue in the USA almost 20% of Americans experience anxiety problems each year. Anxiety is particularly common for people with epilepsy four people in 10 with epilepsy have an anxiety disorder.
Here is everything you need to know about anxiety and seizures.
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Nes That Have A Psychological Cause
In addition to dissociative seizures, there are other types of seizures that have a psychological cause:.
- Panic attacks can happen in frightening situations, when remembering previous frightening experiences or in a situation that the person expects to be frightening. Panic attacks can cause sweating, palpitations , trembling and difficulty breathing. The person may also lose consciousness and shake.
- Factitious seizures means that the person has some level of conscious control over them. An example of this is when seizures form part of Münchausens Syndrome, a rare psychiatric condition where a person is driven by a need to have medical investigations and treatments.
Whatever type of seizures you are having you might like to talk to someone about your diagnosis and how you feel about it.
Call our confidential helpline if you want to talk.
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What Does A Seizure Look Like
So Ill start off by saying that seizure activity typically involves a loss of consciousness along with what we call tonic-clonic muscle contractions. So that’s where we have the typical seizure activity where their legs, and their other muscles, contract and then relax, or they contract in an alternating way.
This then causes the legs to start extending and then contracting, extending and contracting and we get the tremors and rigidity that we would typically associate with having fits.
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Can Heart Problems Cause Seizures
Based on an article titled Epilepsy and hypertension: The possible link for sudden unexpected death in epilepsy?
Originally written by Szczurkowska et al., 2021
Seizures are described as sudden and uncontrollable electrical disturbances in the brain. They lead to temporary changes in behaviour, feelings, movements, and ultimately the person experiencing this can become unconscious.1 However, an individual who is said to experience two or more episodes of seizures are diagnosed with epilepsy.
How Might Seizures Cause Anxiety
Its natural to experience feelings of anxiety in the wake of a seizure or if a doctor has just given you an epilepsy diagnosis.
As with many chronic conditions and traumatic events, seizures can be unsettling, and some people find them scary. Seizure symptoms that may worry some people include:
- heart palpitations
- loss of motor control
Knowing a seizure could occur without warning might lead you to feel anxious in social or public settings. This element of surprise may take a serious toll on your mental well-being.
Unfortunately, the stigma of epilepsy and seizures is also very real and may contribute to your anxiety.
have found that the brain regions and mechanisms involved in seizures overlap with those critical to anxiety.
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Differences Between A Stroke And A Seizure
Aug 06, 2021Jasmine Aimaq
Lisa M. Bateman, MD
For easy reference, think of it this way. Stroke: blood. Seizure: electricity.
Both involve a disruption of normal activities in the brain and come on as attacks. They can be mild or severe, and both have a known set of symptoms. Confusion and loss of muscle control are signs of a seizure. The trouble is that they can also be signs of a stroke.
Shlee S. Song, MD
Habit Of Pushing Back Unwanted Memories
Many people respond to traumatic or distressing memories by burying them or pushing them away.
If your worries overwhelm and exhaust you to the point where you begin to have trouble functioning, you might try to block or suppress them in order to cope.
You might not forget a specific event entirely, but refusing to think about it can blur the details and help it fade from the forefront of your memory.
Suppression might seem beneficial, but it doesnt help you address the source of the problem. Unaddressed anxiety can get worse and have an even greater effect on memory and concentration over time.
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How Can I Reduce My Risk
Everyone is at risk for seizures, and they also happen unpredictably, so its not possible to completely prevent them. The best thing you can do is avoid possible causes to reduce the chances of having a seizure.
The best things you can do to reduce your risk of having a seizure include:
- Eat a balanced diet and maintain a weight thats healthy for you. Many conditions related to your circulatory and heart health, especially stroke, can damage areas of your brain. This is one of the main causes of seizures in people over age 65. This can also help avoid electrolyte problems .
- Dont ignore infections. Eye and ear infections are especially important to treat. If these infections spread to your brain, they can cause seizures. Infections can also cause high fevers, which can lead to seizures.
- Wear safety equipment. Head injuries are a major cause of seizures. Using safety equipment whenever necessary can help you avoid an injury that leads to a seizure.
- Dont misuse alcohol, prescription or recreational drugs. Misusing these can lead to seizures, and withdrawal from these substances can also lead to seizures if youre dependent on them.
- Manage your health conditions. Managing chronic conditions can help you avoid seizures, especially those that happen because of your blood sugar with either Type 1 diabetes or Type 2 diabetes.
- Avoid possible seizure triggers. People with a history of seizures from flashing lights should use caution and avoid similar triggers whenever possible.
Implications For Clinical Practice
During the past 2-3 years several studies have better defined the clinical characteristics, and molecular and electrophysiologic biomarkers that can be reliably used to predict poor long-term outcomes for those who survive OHCA. Thus, patients who are comatose and have absent pupillary and corneal reflexes, no spontaneous circulation after arrest for more than 25 minutes, are older than age 70, and have serum NSE levels greater than 80 ng/ml and bilaterally absent N20 waves on SSEPs 3 or more days after the arrest will have a poor long-term outcome. Unfortunately, however, there still has been little progress toward defining clinical or laboratory characteristics that will reliably predict good outcomes. No new therapies for OHCA have been identified, but recent trials have better defined the short- and long-term effects of therapeutic hypothermia.
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