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Case Reports
. 2021 Oct;11(5):e747-e749.
doi: 10.1212/CPJ.0000000000000979.

Postictal Atrial Fibrillation: A Potential Biomarker for Severe Autonomic Dysfunction and SUDEP?

Russell Nightscales  1 , Paul B Sparks  1 , Terence J O'Brien  1 , Piero Perucca  1 , Shobi Sivathamboo  1
Affiliations
Case Reports

Postictal Atrial Fibrillation: A Potential Biomarker for Severe Autonomic Dysfunction and SUDEP?

Russell Nightscales et al. Neurol Clin Pract. 2021 Oct.
No abstract available

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Figures

Figure
Figure. Timeline and EEG-ECG Segments Recorded During Inpatient Video-EEG Monitoring
(A) Timeline showing sequence of 2 back-to-back FBTCSs with cardiorespiratory and autonomic dysfunction. (B) Seizure one begins with an insidious onset over the left temporal region (left panel), which subsequently evolves to polymorphic delta-theta activity over the same region (right panel, starting at 1:14 minutes from the EEG seizure-onset). (C) Seizure one is followed by diffuse postictal EEG attenuation lasting 17 s and resembling PGES, but interpretation is hampered by substantial EMG artefact. Clinically, this is accompanied by stertorous breathing. (D) Onset of PIAF occurs 1:31 minutes after seizure termination. Bipolar channels with C3 were removed because of prominent artefact. Filters applied to the EEG were low pass 70 Hz, high pass 50 Hz and notch 50 Hz. FBTCS = focal-to-bilateral tonic-clonic seizure; PGES = postictal generalised EEG suppression; PIAF = postictal atrial fibrillation; S1 = seizure 1; S2 = seizure 2.
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