Myocardial infarction following convulsive and nonconvulsive seizures

Myocardial infarction (MI) has been rarely reported in association with seizures, and only of convulsive type. Methods: We describe a series of five patients observed over a 4-year period, who presented MI immediately following seizures, either convulsive or nonconvulsive. Results: Patient 1 had pre-existent coronary disease (CD) and presented multiple focal nonconvulsive seizures. Patient 2 had no CD, normal coronary angiography and presented secondary generalized convulsive seizures. Patient 3 had no history of CD, normal angiography and had a first single convulsive seizure. Patient 4 had severe CD and suffered from a single convulsive event. Patient 5 had a partial and a generalized seizure and had no known CD. Conclusions: MI following seizures is not an exceptional event and can occur in a spectrum of conditions including single or repeated, convulsive or nonconvulsive seizures, in patients with or without preexisting coronary disease. We suggest that the occurrence of MI should be considered in epileptic patients during and shortly after seizures.