Analysis of electrocardiographic changes in status epilepticus.

The high mortality associated with status epilepticus (SE) has been hypothesized to result partially from neurologically induced changes in cardiac function. To test this hypothesis, we reviewed electrocardiograms of 60 patients presenting in status epilepticus. Sequential electrocardiograms before, during and after ictal episodes were compared to define changes from baseline studies. 58.3% of the SE patients (N = 35) exhibited significant abnormalities on electrocardiograms obtained within 24 h of status epilepticus. Specific electrocardiographic changes included arrhythmias, axis changes, conduction abnormalities and ischemic patterns. All of these abnormal ECG changes met generally accepted cardiologic standards for a high risk of myocardial dysfunction or ischemia. The association of ECG changes with mortality was statistically significant. These results indicate that a significant proportion of SE patients are at risk for cardiac dysfunction and that close monitoring of cardiac function is indicated during and after SE.