Peri-ictal brainstem posturing, breathing compromise, and generalized convulsive seizures

Takeaway

  • Peri-ictal brainstem posturing (PIBP) is associated with generalized convulsive seizures (GCS) with longer post-ictal generalized electroencephalographic suppression (PGES), and more severe breathing abnormalities.

Why this matters

  • GCS tonic phase semiology and duration is related to PGES incidence, which has, in turn been linked to sudden unexplained death in epilepsy (SUDEP); however, its association with post-ictal cardiorespiratory compromise has not yet been elucidated.

  • PIBP may constitute clinical phenotypic biomarkers for GCS severity without in-hospital monitoring, potentially reducing diagnosis timeframes, hospital admission-associated costs, and inconvenience to patients without easy access to healthcare facilities.