Ictal sinus pause and myoclonic seizure in a child

Hye Ryun Kim, Gun Ha Kim, So Hee Eun, Baik Lin Eun, Jung Hye Byeon

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    1 Citation (Scopus)


    Ictal tachycardia and bradycardia are common arrhythmias; however, ictal sinus pause and asystole are rare. Ictal arrhythmia is mostly reported in adults with temporal lobe epilepsy. Recently, ictal arrhythmia was recognized as a major warning sign of sudden unexpected death in epilepsy. We present an interesting case of a child with ictal sinus pause and asystole. A 27-month-old girl was hospitalized due to 5 episodes of convulsions during the past 2 days. Results of routine electroencephalography (EEG) were normal, but she experienced brief generalized tonic seizure for 3 days. During video-monitored EEG and echocardiography (ECG), she showed multiple myoclonic seizures simultaneously or independently, as well as frequent sinus pauses. After treatment with valproic acid, myoclonus and generalized tonic seizures were well controlled and only 2 sinus pauses were seen on 24-hour Holter ECG monitoring. Sinus dysfunction should be recognized on EEG, and it can sometimes be treated successfully with only antiepileptic medication.

    Original languageEnglish
    Pages (from-to)S129-S132
    JournalKorean Journal of Pediatrics
    Publication statusPublished - 2016 Nov


    • Asystole
    • Electroencephalography
    • Sinus pause

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health
    • Pediatrics


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