{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:49:36Z","timestamp":1791265776051,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2013,6,12]],"date-time":"2013-06-12T00:00:00Z","timestamp":1370995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000065","name":"NINDS","doi-asserted-by":"crossref","award":["NS076965-01"],"award-info":[{"award-number":["NS076965-01"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Periictal autonomic dysregulation is best studied using a \u201cpolygraphic\u201d approach: electroencephalography ([<jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content>]), 3\u2010channel electrocardiography [<jats:styled-content style=\"fixed-case\">ECG<\/jats:styled-content>], pulse oximetry, respiration, and continuous noninvasive blood pressure [<jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>]), which may help elucidate agonal pathophysiologic mechanisms leading to sudden unexpected death in epilepsy (<jats:styled-content style=\"fixed-case\">SUDEP<\/jats:styled-content>). A number of autonomic phenomena have been described in generalized tonic\u2013clonic seizures (<jats:styled-content style=\"fixed-case\">GTCS<\/jats:styled-content>), the most common seizure type associated with <jats:styled-content style=\"fixed-case\">SUDEP<\/jats:styled-content>, including decreased heart rate variability, cardiac arrhythmias, and changes in skin conductance. Postictal generalized <jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content> suppression (<jats:styled-content style=\"fixed-case\">PGES<\/jats:styled-content>) has been identified as a potential risk marker of <jats:styled-content style=\"fixed-case\">SUDEP<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">PGES<\/jats:styled-content> has been found to correlate with post\u2010<jats:styled-content style=\"fixed-case\">GTCS<\/jats:styled-content> autonomic dysregulation in some patients. Herein, we describe a patient with a <jats:styled-content style=\"fixed-case\">GTCS<\/jats:styled-content> in whom polygraphic measurements were obtained, including continuous noninvasive blood pressure recordings. Significant postictal hypotension lasting &gt;60\u00a0s was found, which closely correlated with <jats:styled-content style=\"fixed-case\">PGES<\/jats:styled-content> duration. Similar <jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content> changes are well described in hypotensive patients with vasovagal syncope and a similar vasodepressor phenomenon, and consequent cerebral hypoperfusion may account for the <jats:styled-content style=\"fixed-case\">PGES<\/jats:styled-content> observed in some patients after a <jats:styled-content style=\"fixed-case\">GTCS<\/jats:styled-content>. This further raises the possibility that profound, prolonged, and irrecoverable hypotension may comprise one potential <jats:styled-content style=\"fixed-case\">SUDEP<\/jats:styled-content> mechanism.<\/jats:p>","DOI":"10.1111\/epi.12251","type":"journal-article","created":{"date-parts":[[2013,6,12]],"date-time":"2013-06-12T17:24:48Z","timestamp":1371057888000},"source":"Crossref","is-referenced-by-count":63,"title":["Significant postictal hypotension: Expanding the spectrum of seizure\u2010induced autonomic dysregulation"],"prefix":"10.1111","volume":"54","author":[{"given":"Alireza","family":"Bozorgi","sequence":"first","affiliation":[{"name":"Epilepsy Center Neurological Institute University Hospitals Case Medical Center Cleveland Ohio U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Chung","sequence":"additional","affiliation":[{"name":"Epilepsy Center Neurological Institute University Hospitals Case Medical Center Cleveland Ohio U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farhad","family":"Kaffashi","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering and Computer Science Case School of Engineering Case Western Reserve University Cleveland Ohio U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth A.","family":"Loparo","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering and Computer Science Case School of Engineering Case Western Reserve University Cleveland Ohio U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satya","family":"Sahoo","sequence":"additional","affiliation":[{"name":"Division of Medical Informatics Case Western Reserve University School of Medicine Cleveland Ohio U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Q.","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Medical Informatics Case Western Reserve University School of Medicine Cleveland Ohio U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kitti","family":"Kaiboriboon","sequence":"additional","affiliation":[{"name":"Epilepsy Center Neurological Institute University Hospitals Case Medical Center Cleveland Ohio U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samden D.","family":"Lhatoo","sequence":"additional","affiliation":[{"name":"Epilepsy Center Neurological Institute University Hospitals Case Medical Center Cleveland Ohio U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,6,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.29.11.2347"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004691-199705000-00004"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11684-013-0239-5"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.compbiomed.2005.04.003"},{"key":"e_1_2_7_6_1","first-page":"28","volume-title":"Epileptic seizures: clinical and electrographic features, diagnosis and treatment","author":"Gastaut H","year":"1972"},{"key":"e_1_2_7_7_1","first-page":"189","article-title":"Beat\u2010to\u2010beat hemodynamic monitoring during electroconvulsive therapy","volume":"27","author":"Geersing PG","year":"2011","journal-title":"JECT"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aer499"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.78.5.481"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22101"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000114609"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-75434-5_6"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/9780203091708-59"},{"key":"e_1_2_7_14_1","unstructured":"J Penaz 1973 Digest of the 10th International Conference on Medical and Biological Engineering. 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