Ictal hypoxemia in localization-related epilepsy: analysis of incidence, severity and risk factors

摘要: Ictal hypoxemia has been reported in small series of cases and may contribute to sudden unexpected death epilepsy (SUDEP). We sought determine the incidence severity ictal patients with localization-related undergoing in-patient video-EEG telemetry. examined whether seizureassociated oxygen desaturation was a consequence hypoventilation factors such as seizure localization lateralization, duration, contralateral spread seizures, patient position at onset body mass index influenced ictal-related hypoxemia. A total 304 seizures accompanying saturation data were recorded 56 consecutive intractable epilepsy; 51 progressed generalized convulsions. Pulse oximetry showed desaturations below 90% 101 (33.2%) all or without secondary generalization, 31 (10.2%) accompanied by 80% 11 (3.6%) 70%. The mean duration 69.2 � 65.2 s (47; 6^327). nadir following generalization 75.4% 11.4% (77%; 42^100%). Desaturations significantly correlated [P = 0.005; odds ratio (OR) temporal versus extratemporal 5.202; 95% CI (1.665, 16.257)], lateralization 0.001; OR right left 2.098; (1.078, 4.085)], 0.028; no 2.591; (1.112, 6.039)] gender =0 .048; female male 0.422; (0.179, 0.994)]. In subset 253 partial convulsions, 34.8% had 90%, 31.8% 12.5% degree (P 0.001) electrographic evidence hemisphere 0.003). Central apnoeas hypopnoeas occurred 50% 100 seizures. Mixed obstructive 9% these End-tidal carbon dioxide (ETCO2) seven (19 seizures). increase ETCO2 from preictal baseline 18.6 17.7 mm Hg (13.2; 2.8^77.8). 19 85% an ETCO2. occurs often be pronounced prolonged; even that do not progress Oxygen are increases ETCO2, supporting assumption is hypoventilation. hypercapnia SUDEP.