Skip to main content
SpringerLink
Log in

Kardiale und zerebrovaskuläre Erkrankungen bei Epilepsie

Ursachen, Zusammenhänge und Folgen

Cardiac and cerebrovascular diseases in epilepsy

Causes, associations and consequences

  • Leitthema
  • Published:
Zeitschrift für Epileptologie Aims and scope Submit manuscript

Zusammenfassung

Kardiovaskuläre Risikofaktoren sind bei Epilepsiepatienten weit verbreitet und prädisponieren zu zerebrovaskulären Erkrankungen und vaskulär bedingten Epilepsien. Umgekehrt können Epilepsien und Antikonvulsiva einen negativen Einfluss auf das kardiovaskuläre Risiko haben. Insbesondere der Einsatz enzyminduzierender Antikonvulsiva kann Dyslipidämien, Übergewicht oder Hyperhomozysteinämien verursachen oder verstärken. Kardiovaskuläre Erkrankungen können Epilepsien oder akut-symptomatische Anfälle bedingen, z. B. durch Hirninfarkte, Hirnblutungen, zerebrale Hypoxien und hypertensive Krisen. Die allgemeine und kardiovaskuläre Mortalität ist bei Menschen mit Epilepsie erhöht. Sie erleiden im Vergleich zur Allgemeinbevölkerung häufiger und früher Schlaganfälle, Herzinfarkte und einen plötzlichen Herztod. Epileptische Anfälle können zu Störungen der koronaren Durchblutung, Herzmuskelmechanik und des Herzrhythmus führen. Die kardiale Belastung durch Anfälle findet ihren Ausdruck in EKG-Veränderungen und Troponin-Erhöhungen. Herzrhythmusstörungen sind eine häufige Folge epileptischer Anfälle. Iktale und postiktale Tachykardien sind häufig, diagnostisch nützlich und nur selten gefährlich. Iktale Bradykardien und Asystolien können typischerweise selbstlimitierende Synkopen auslösen, postiktale Asystolien enden hingegen unbehandelt nicht selten tödlich. Synkopen sind die häufigste Differenzialdiagnose zu epileptischen Anfällen. Antikonvulsiva und in sehr seltenen Fällen auch die Vagusnervstimulation können arrhythmogene Wirkungen entfalten, hier ist daher insbesondere bei herzkranken Patienten Vorsicht geboten.

Abstract

People with epilepsy commonly display cardiovascular risk factors which predispose to cerebrovascular diseases and vascular-linked epilepsies. Conversely, epilepsies and anticonvulsant drugs can have negative effects on cardiovascular risks. In particular, enzyme-inducing anticonvulsant drugs may cause or worsen dyslipidemia, overweight or hyperhomocysteinemia. Cardiovascular diseases may cause epilepsies and acute symptomatic seizures, e.g. by ischemic or hemorrhagic stroke, cerebral hypoxia and hypertensive crises. Cardiovascular and total mortality are both elevated in people with epilepsy. They suffer from stroke, heart attacks and sudden cardiac death more frequently and at younger ages than the general population. Epileptic seizures can lead to disturbances of coronary blood flow, heart muscle mechanics and cardiac rhythm. The cardiac stress of seizures is reflected by ECG changes and troponin increases. Cardiac arrhythmias are a frequent consequence of epileptic seizures. Ictal and postictal tachycardias are common, diagnostically useful and rarely dangerous. Ictal bradycardia and asystole can trigger usually self-limiting syncope, while postictal asystole may lead to death. Syncope is the most common differential diagnosis to epileptic seizures. Anticonvulsants and more rarely vagal nerve stimulation can have arrhythmogenic effects. Caution is advised, especially in patients with heart disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1

Literatur

  1. Altenmüller DM, Zehender M, Schulze-Bonhage A (2004) High-grade atrioventricular block triggered by spontaneous and stimulation-induced epileptic activity in the left temporal lobe. Epilepsia 45:1640–1644

    Article  PubMed  Google Scholar 

  2. Van Andel J, Ungureanu C, Aarts R et al (2015) Using photoplethysmography in heart rate monitoring of patients with epilepsy. Epilepsy Behav 45:142–145

    Article  PubMed  Google Scholar 

  3. Bardai A, Lamberts RJ, Blom MT et al (2012) Epilepsy is a risk factor for sudden cardiac arrest in the general population. PLOS ONE 7:e42749

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Bateman BT, Claassen J, Willey JZ et al (2007) Convulsive status epilepticus after ischemic stroke and intracerebral hemorrhage: frequency, predictors, and impact on outcome in a large administrative dataset. Neurocrit Care 7:187–193

    Article  PubMed  Google Scholar 

  5. Bauer S, Koller M, Cepok S et al (2008) NK and CD4+ T cell changes in blood after seizures in temporal lobe epilepsy. Exp Neurol 211:370–377

    Article  CAS  PubMed  Google Scholar 

  6. Beghi E, D’alessandro R, Beretta S et al (2011) Incidence and predictors of acute symptomatic seizures after stroke. Neurology 77:1785–1793

    Article  CAS  PubMed  Google Scholar 

  7. Benninger F, Holtkamp M (2017) Epileptic seizures and epilepsy after a stroke : Incidence, prevention and treatment. Nervenarzt. https://doi.org/10.1007/s00115-017-0358-3

    PubMed  Google Scholar 

  8. Bestawros M, Darbar D, Arain A et al (2015) Ictal asystole and ictal syncope: insights into clinical management. Circ Arrhythm Electrophysiol 8:159–164

    Article  PubMed  Google Scholar 

  9. Billinghurst LL, Beslow LA, Abend NS et al (2017) Incidence and predictors of epilepsy after pediatric arterial ischemic stroke. Neurology 88:630–637

    Article  PubMed  Google Scholar 

  10. Blad H, Lamberts RJ, Van Dijk GJ et al (2015) Tilt-induced vasovagal syncope and psychogenic pseudosyncope: overlapping clinical entities. Neurology 85:2006–2010

    Article  PubMed  PubMed Central  Google Scholar 

  11. Chang CS, Liao CH, Lin CC et al (2014) Patients with epilepsy are at an increased risk of subsequent stroke: a population-based cohort study. Seizure 23:377–381

    Article  PubMed  Google Scholar 

  12. Chen Z, Liew D, Kwan P (2016) Excess mortality and hospitalized morbidity in newly treated epilepsy patients. Neurology 87:718–725

    Article  PubMed  PubMed Central  Google Scholar 

  13. Cui W, Zack MM, Kobau R et al (2015) Health behaviors among people with epilepsy – results from the 2010 National Health Interview Survey. Epilepsy Behav 44:121–126

    Article  PubMed  PubMed Central  Google Scholar 

  14. Datar S, Singh T, Rabinstein AA et al (2015) Long-term risk of seizures and epilepsy in patients with posterior reversible encephalopathy syndrome. Epilepsia 56:564–568

    Article  PubMed  Google Scholar 

  15. Van Der Lende M, Surges R, Sander JW et al (2016) Cardiac arrhythmias during or after epileptic seizures. J Neurol Neurosurg Psychiatr 87:69–74

    Google Scholar 

  16. Devinsky O, Spruill T, Thurman D et al (2016) Recognizing and preventing epilepsy-related mortality: a call for action. Neurology 86:779–786

    Article  PubMed  PubMed Central  Google Scholar 

  17. Van Dijk JG, Thijs RD, Van Zwet E et al (2014) The semiology of tilt-induced reflex syncope in relation to electroencephalographic changes. Brain 137:576–585

    Article  PubMed  Google Scholar 

  18. Duplyakov D, Golovina G, Lyukshina N et al (2014) Syncope, seizure-induced bradycardia and asystole: two cases and review of clinical and pathophysiological features. Seizure 23:506–511

    Article  PubMed  Google Scholar 

  19. Eggleston KS, Olin BD, Fisher RS (2014) Ictal tachycardia: the head-heart connection. Seizure 23:496–505

    Article  PubMed  Google Scholar 

  20. Einhaupl K, Stam J, Bousser MG et al (2010) EFNS guideline on the treatment of cerebral venous and sinus thrombosis in adult patients. Eur J Neurol 17:1229–1235

    Article  CAS  PubMed  Google Scholar 

  21. Elliott JO, Lu B, Moore JL et al (2008) Exercise, diet, health behaviors, and risk factors among persons with epilepsy based on the California Health Interview Survey, 2005. Epilepsy Behav 13:307–315

    Article  PubMed  Google Scholar 

  22. Elliott JO, Moore JL, Lu B (2008) Health status and behavioral risk factors among persons with epilepsy in Ohio based on the 2006 Behavioral Risk Factor Surveillance System. Epilepsy Behav 12:434–444

    Article  PubMed  Google Scholar 

  23. Ferlazzo E, Gasparini S, Beghi E et al (2016) Epilepsy in cerebrovascular diseases: review of experimental and clinical data with meta-analysis of risk factors. Epilepsia 57:1205–1214

    Article  PubMed  Google Scholar 

  24. Fisher RS, Afra P, Macken M et al (2016) Automatic vagus nerve stimulation triggered by Ictal tachycardia: clinical outcomes and device performance – the U.S. E‑37 trial. Neuromodulation 19:188–195

    Article  PubMed  Google Scholar 

  25. Forsgren L, Beghi E, Oun A et al (2005) The epidemiology of epilepsy in Europe – a systematic review. Eur J Neurol 12:245–253

    Article  CAS  PubMed  Google Scholar 

  26. French LK, Mckeown NJ, Hendrickson RG (2011) Complete heart block and death following lamotrigine overdose. Clin Toxicol (Phila) 49:330–333

    Article  CAS  Google Scholar 

  27. Gaitatzis A, Carroll K, Majeed A et al (2004) The epidemiology of the comorbidity of epilepsy in the general population. Epilepsia 45:1613–1622

    Article  PubMed  Google Scholar 

  28. Gibson LM, Hanby MF, Al-Bachari SM et al (2014) Late-onset epilepsy and occult cerebrovascular disease. J Cereb Blood Flow Metab 34:564–570

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Haapaniemi E, Strbian D, Rossi C et al (2014) The CAVE score for predicting late seizures after intracerebral hemorrhage. Stroke 45:1971–1976

    Article  PubMed  Google Scholar 

  30. Hamed SA (2014) Atherosclerosis in epilepsy: its causes and implications. Epilepsy Behav 41:290–296

    Article  PubMed  Google Scholar 

  31. Hamer HM (2009) Epileptische Anfälle und Epilepsien nach „Schlaganfall“. Nervenarzt 80:405–414

    Article  CAS  PubMed  Google Scholar 

  32. Hampel KG, Jahanbekam A, Elger CE et al (2016) Seizure-related modulation of systemic arterial blood pressure in focal epilepsy. Epilepsia 57:1709–1718

    Article  CAS  PubMed  Google Scholar 

  33. Hampel KG, Elger CE, Surges R (2017) Impaired Baroreflex sensitivity after bilateral convulsive seizures in patients with focal epilepsy. Front Neurol 8:210

    Article  PubMed  PubMed Central  Google Scholar 

  34. Hampel KG, Thijs RD, Elger CE, Surges R (2017) Recurrence risk of ictal asystole in epilepsy. Neurology. pii:10.1212/WNL.0000000000004266. https://doi.org/10.1212/WNL.0000000000004266. [Epub ahead of print]

    PubMed  PubMed Central  Google Scholar 

  35. Hansen J, Asberg S, Kumlien E et al (2017) Cause of death in patients with poststroke epilepsy: results from a nationwide cohort study. PLOS ONE 12:e174659

    Article  PubMed  PubMed Central  Google Scholar 

  36. Horrocks IA, Nechay A, Stephenson JB et al (2005) Anoxic-epileptic seizures: observational study of epileptic seizures induced by syncopes. Arch Dis Child 90:1283–1287

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Hsieh CY, Lai EC, Yang YH et al (2013) Comparative stroke risk of antiepileptic drugs in patients with epilepsy. Epilepsia 54:172–180

    Article  CAS  PubMed  Google Scholar 

  38. Hulbert J, Elger CE, Meyer R et al (2017) Antiepileptic drugs impair shortening of isolated cardiomyocytes. Front Neurol 8:133

    Article  PubMed  PubMed Central  Google Scholar 

  39. Iriarte J, Urrestarazu E, Alegre M et al (2009) Late-onset periodic asystolia during vagus nerve stimulation. Epilepsia 50:928–932

    Article  PubMed  Google Scholar 

  40. Janousek J, Barber A, Goldman L et al (2013) Obesity in adults with epilepsy. Epilepsy Behav 28:391–394

    Article  PubMed  Google Scholar 

  41. Katsiki N, Mikhailidis DP, Nair DR (2014) The effects of antiepileptic drugs on vascular risk factors: a narrative review. Seizure 23:677–684

    Article  PubMed  Google Scholar 

  42. Kenneback G, Ericson M, Tomson T et al (1997) Changes in arrhythmia profile and heart rate variability during abrupt withdrawal of antiepileptic drugs. Implications for sudden death. Seizure 6:369–375

    Article  CAS  PubMed  Google Scholar 

  43. Klein KM (2017) Synkopen. Z Epileptol 30:39–44

    Article  Google Scholar 

  44. Knake S, Rochon J, Fleischer S et al (2006) Status epilepticus after stroke is associated with increased long-term case fatality. Epilepsia 47:2020–2026

    Article  PubMed  Google Scholar 

  45. Kobau R, Zahran H, Thurman DJ et al (2008) Epilepsy surveillance among adults – 19 states, behavioral risk factor surveillance system, 2005. MMWR Surveill Summ 57:1–20

    PubMed  Google Scholar 

  46. Kohno R, Abe H, Akamatsu N et al (2016) Long-term follow-up of ictal asystole in temporal lobe epilepsy: is permanent pacemaker therapy needed? J Cardiovasc Electrophysiol 27:930–936

    Article  PubMed  Google Scholar 

  47. Krause LU, Brodowski KO, Kellinghaus C (2011) Atrioventricular block following lacosamide intoxication. Epilepsy Behav 20:725–727

    Article  PubMed  Google Scholar 

  48. Lamberts RJ, Blom MT, Wassenaar M et al (2015) Sudden cardiac arrest in people with epilepsy in the community: circumstances and risk factors. Neurology 85:212–218

    Article  PubMed  PubMed Central  Google Scholar 

  49. Linnebank M, Moskau S, Semmler A et al (2011) Antiepileptic drugs interact with folate and vitamin B12 serum levels. Ann Neurol 69:352–359

    Article  CAS  PubMed  Google Scholar 

  50. Lotufo PA, Valiengo L, Bensenor IM et al (2012) A systematic review and meta-analysis of heart rate variability in epilepsy and antiepileptic drugs. Epilepsia 53:272–282

    Article  PubMed  Google Scholar 

  51. Marti-Carvajal AJ, Sola I, Lathyris D (2015) Homocysteine-lowering interventions for preventing cardiovascular events. Cochrane Database Syst Rev 1:CD6612

    PubMed  Google Scholar 

  52. Mathias CJ, Deguchi K, Schatz I (2001) Observations on recurrent syncope and presyncope in 641 patients. Lancet 357:348–353

    Article  CAS  PubMed  Google Scholar 

  53. Moseley BD, Ghearing GR, Benarroch EE et al (2011) Early seizure termination in ictal asystole. Epilepsy Res 97:220–224

    Article  PubMed  Google Scholar 

  54. Moseley BD, Ghearing GR, Munger TM et al (2011) The treatment of ictal asystole with cardiac pacing. Epilepsia 52:e16–e19

    Article  PubMed  Google Scholar 

  55. Nass RD, Meiling S, Surges R et al (2016) Laborchemische Marker kardialer und metabolischer Komplikationen nach generalisierten tonisch klonischen Anfällen. 89. Kongress der Deutschen Gesellschaft für Neurologie, Mannheim, S 193

    Google Scholar 

  56. Nass RD, Sassen R, Elger CE et al (2017) The role of postictal laboratory blood analyses in the diagnosis and prognosis of seizures. Seizure 47:51–65

    Article  PubMed  Google Scholar 

  57. Nevalainen O, Ansakorpi H, Simola M et al (2014) Epilepsy-related clinical characteristics and mortality: a systematic review and meta-analysis. Neurology 83:1968–1977

    Article  CAS  PubMed  Google Scholar 

  58. Nizam A, Mylavarapu K, Thomas D et al (2011) Lacosamide-induced second-degree atrioventricular block in a patient with partial epilepsy. Epilepsia 52:e153–e155

    Article  CAS  PubMed  Google Scholar 

  59. Olesen JB, Abildstrom SZ, Erdal J et al (2011) Effects of epilepsy and selected antiepileptic drugs on risk of myocardial infarction, stroke, and death in patients with or without previous stroke: a nationwide cohort study. Pharmacoepidemiol Drug Saf 20:964–971

    Article  CAS  PubMed  Google Scholar 

  60. Olesen JB, Hansen PR, Abildstrom SZ et al (2011) Valproate attenuates the risk of myocardial infarction in patients with epilepsy: a nationwide cohort study. Pharmacoepidemiol Drug Saf 20:146–153

    Article  CAS  PubMed  Google Scholar 

  61. Patorno E, Glynn RJ, Hernandez-Diaz S et al (2013) Risk of ischemic cerebrovascular and coronary events in adult users of anticonvulsant medications in routine care settings. J Am Heart Assoc 2:e208

    Article  PubMed  PubMed Central  Google Scholar 

  62. Petkar S, Hamid T, Iddon P et al (2012) Prolonged implantable electrocardiographic monitoring indicates a high rate of misdiagnosis of epilepsy – REVISE study. Europace 14:1653–1660

    Article  PubMed  Google Scholar 

  63. Ravindran K, Powell KL, Todaro M et al (2016) The pathophysiology of cardiac dysfunction in epilepsy. Epilepsy Res 127:19–29

    Article  CAS  PubMed  Google Scholar 

  64. Renoux C, Dell’aniello S, Saarela O et al (2015) Antiepileptic drugs and the risk of ischaemic stroke and myocardial infarction: a population-based cohort study. BMJ Open 5:e8365

    Article  PubMed  PubMed Central  Google Scholar 

  65. Roach ES, Golomb MR, Adams R et al (2008) Management of stroke in infants and children: a scientific statement from a Special Writing Group of the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young. Stroke 39:2644–2691

    Article  PubMed  Google Scholar 

  66. Roston TM, Cunningham T, Lehman A et al (2017) Beyond the electrocardiogram: mutations in cardiac Ion channel genes underlie nonarrhythmic phenotypes. Clin Med Insights Cardiol 11:1179546817698134

    Article  PubMed  PubMed Central  Google Scholar 

  67. Ryvlin P, Nashef L, Lhatoo SD et al (2013) Incidence and mechanisms of cardiorespiratory arrests in epilepsy monitoring units (MORTEMUS): a retrospective study. Lancet Neurol 12:966–977

    Article  PubMed  Google Scholar 

  68. Schuele SU, Bermeo AC, Alexopoulos AV et al (2007) Video-electrographic and clinical features in patients with ictal asystole. Neurology 69:434–441

    Article  CAS  PubMed  Google Scholar 

  69. Shmuely S, Van Der Lende M, Lamberts RJ et al (2017) The heart of epilepsy: current views and future concepts. Seizure 44:176–183

    Article  CAS  PubMed  Google Scholar 

  70. Simon RP, Aminoff MJ, Benowitz NL (1984) Changes in plasma catecholamines after tonic-clonic seizures. Neurology 34:255–257

    Article  CAS  PubMed  Google Scholar 

  71. Stefanidou M, Das RR, Beiser AS et al (2017) Incidence of seizures following initial ischemic stroke in a community-based cohort: the Framingham Heart Study. Seizure 47:105–110

    Article  PubMed  Google Scholar 

  72. Stephenson J, Breningstall G, Steer C et al (2004) Anoxic-epileptic seizures: home video recordings of epileptic seizures induced by syncopes. Epileptic Disord 6:15–19

    PubMed  Google Scholar 

  73. Strzelczyk A, Cenusa M, Bauer S et al (2011) Management and long-term outcome in patients presenting with ictal asystole or bradycardia. Epilepsia 52:1160–1167

    Article  PubMed  Google Scholar 

  74. Suorsa E, Korpelainen JT, Ansakorpi H et al (2011) Heart rate dynamics in temporal lobe epilepsy – a long-term follow-up study. Epilepsy Res 93:80–83

    Article  PubMed  Google Scholar 

  75. Surges R, Walker MC (2010) Peri-ictal heart rates depend on seizure-type. Seizure 19:453

    Article  PubMed  Google Scholar 

  76. Surges R, Adjei P, Kallis C et al (2010) Pathologic cardiac repolarization in pharmacoresistant epilepsy and its potential role in sudden unexpected death in epilepsy: a case-control study. Epilepsia 51:233–242

    Article  PubMed  Google Scholar 

  77. Surges R, Scott CA, Walker MC (2010) Enhanced QT shortening and persistent tachycardia after generalized seizures. Neurology 74:421–426

    Article  PubMed  PubMed Central  Google Scholar 

  78. Surges R, Taggart P, Sander JW et al (2010) Too long or too short? New insights into abnormal cardiac repolarization in people with chronic epilepsy and its potential role in sudden unexpected death. Epilepsia 51:738–744

    Article  PubMed  Google Scholar 

  79. Thomke F (2013) Assessing prognosis following cardiopulmonary resuscitation and therapeutic hypothermia – a critical discussion of recent studies. Dtsch Arztebl Int 110:137–143

    PubMed  PubMed Central  Google Scholar 

  80. Thurman DJ, Hesdorffer DC, French JA (2014) Sudden unexpected death in epilepsy: assessing the public health burden. Epilepsia 55:1479–1485

    Article  PubMed  Google Scholar 

  81. Tomson T, Kenneback G (1997) Arrhythmia, heart rate variability, and antiepileptic drugs. Epilepsia 38:S48–S51

    Article  CAS  PubMed  Google Scholar 

  82. Torriani O, Vuilleumier F, Perneger T et al (2016) Epilepsy and tobacco smoking: a cross-sectional study. J Neurol 263:2057–2064

    Article  CAS  PubMed  Google Scholar 

  83. Ungar A, Morrione A, Rafanelli M et al (2009) The management of syncope in older adults. Minerva Med 100:247–258

    CAS  PubMed  Google Scholar 

  84. Ungar A, Sgobino P, Russo V et al (2013) Diagnosis of neurally mediated syncope at initial evaluation and with tilt table testing compared with that revealed by prolonged ECG monitoring. An analysis from the Third International Study on Syncope of Uncertain Etiology (ISSUE-3). Heart 99:1825–1831

    Article  PubMed  Google Scholar 

  85. Ungar A, Ceccofiglio A, Pescini F et al (2017) Syncope and Epilepsy coexist in “possible” and “drug-resistant” epilepsy (Overlap between Epilepsy and Syncope Study – OESYS). BMC Neurol 17:45

    Article  PubMed  PubMed Central  Google Scholar 

  86. Velioglu SK, Ozmenoglu M, Boz C et al (2001) Status epilepticus after stroke. Stroke 32:1169–1172

    Article  CAS  PubMed  Google Scholar 

  87. Vivanco-Hidalgo RM, Elosua R, Gomez Gonzalez A et al (2017) People with epilepsy receive more statins than the general population but have no higher cardiovascular risk: results from a cross-sectional study. Eur J Neurol 24:419–426

    Article  CAS  PubMed  Google Scholar 

  88. Vivanco-Hidalgo RM, Gomez A, Moreira A et al (2017) Prevalence of cardiovascular risk factors in people with epilepsy. Brain Behav 7:e618

    Article  PubMed  Google Scholar 

  89. Vyas MV, Davidson BA, Escalaya L et al (2015) Antiepileptic drug use for treatment of epilepsy and dyslipidemia: systematic review. Epilepsy Res 113:44–67

    Article  CAS  PubMed  Google Scholar 

  90. Xu Y, Nguyen D, Mohamed A et al (2016) Frequency of a false positive diagnosis of epilepsy: A systematic review of observational studies. Seizure 41:167–174

    Article  PubMed  Google Scholar 

  91. Zhang C, Wang X, Wang Y et al (2014) Risk factors for post-stroke seizures: a systematic review and meta-analysis. Epilepsy Res 108:1806–1816

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Epileptologie, Uniklinik Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland

    Robert D. Nass & Christian E. Elger

  2. Sektion Epileptologie, Klinik für Neurologie, Uniklinik RWTH Aachen, Pauwelsstraße 30, Aachen, 52074, Deutschland

    Rainer Surges

Authors
  1. Robert D. Nass
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christian E. Elger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rainer Surges
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert D. Nass.

Ethics declarations

Interessenkonflikt

C.E. Elger hat in den letzten 5 Jahren Honorare für Vorträge oder als Berater von Cyberonics, Desitin, Eisai, Medtronics, Novartis, Pfizer, UCB Pharma erhalten. R. Surges hat in den letzten 5 Jahren Honorare für Vorträge oder als Berater von Bial, Cyberonics, Desitin, Eisai, LivaNova, Novartis und UCB Pharma erhalten, und R.D. Nass gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nass, R.D., Elger, C.E. & Surges, R. Kardiale und zerebrovaskuläre Erkrankungen bei Epilepsie. Z. Epileptol. 31, 48–57 (2018). https://doi.org/10.1007/s10309-017-0146-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10309-017-0146-x

Schlüsselwörter

Keywords

Search

Navigation