Bradicardia y convulsiones: una relación multicausal <span class="so-article-trans-title" dir="auto"> Translated title: Bradycardia and seizures: a multi-causal relationship </span>

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Abstract

La disfunción del nodo sinusal consiste en una alteración en la generación del impulso en el nodo sinusal. Su principal causa es la degeneración fibrosa del tejido sinusal. Los casos asociados a convulsiones son multicausales y se deben a los efectos cardiodepresores de los anticonvulsivantes o de sus diluyentes; así mismo se pueden presentar casos de bradicardia y asistolia inducidos por las descargas epilépticas. Se expone el caso de una paciente con status epiléptico tratada con fenitoína endovenosa, quien recibía previamente carbamazepina y desarrolló disfunción del nodo sinusal considerada como un efecto secundario tóxico de su medicación anticonvulsivante.

Translated abstract

Sinus node dysfunction is an alteration in the impulse generation in the sinus node. Its main cause is the fibrous degeneration of the sinus tissue. Cases associated with seizures have multiple causes and are due to the cardio-depressant effects of anticonvulsants or its diluents. Likewise, there may be cases of bradycardia and asystole induced by epileptic discharges. Here is presented the case of a female patient with status epilepticus who was treated with intravenous phenytoin and was previously receiving and developed sinus node dysfunction which was considered as a toxic side effect of her anticonvulsant medication.

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Most cited references 14

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Diagnosis and treatment of sick sinus syndrome.

Victor Adán, A Crown (2003)

Sick sinus syndrome comprises a variety of conditions involving sinus node dysfunction and commonly affects elderly persons. While the syndrome can have many causes, it usually is idiopathic. Patients may experience syncope, pre-syncope, palpitations, or dizziness; however, they often are asymptomatic or have subtle or nonspecific symptoms. Sick sinus syndrome has multiple manifestations on electrocardiogram, including sinus bradycardia, sinus arrest, sinoatrial block, and alternating patterns of bradycardia and tachycardia (bradycardia-tachycardia syndrome). Diagnosis of sick sinus syndrome can be difficult because of its nonspecific symptoms and elusive findings on electrocardiogram or Holter monitor. The mainstay of treatment is atrial or dual-chamber pacemaker placement, which generally provides effective relief of symptoms and lowers the incidence of atrial fibrillation, thromboembolic events, heart failure, and mortality, compared with ventricular pacemakers.