Bradycardia and syncope as manifestations of partial epilepsy

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Constantin L, Martins JB, Fincham RW, and Dagli RD (1990) Bradycardia and syncope as manifestations of partial epilepsy. J Am Coll Cardiol 15:4 900–5.

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Abstract: Although transient increases in heart rate typically occur, bradycardia has infrequently been noted in association with partial seizures. Five patients with temporal lobe epilepsy are described in whom sinus bradyarrhythmias and syncope were prominent manifestations of seizure activity. Partial improvement occurred in one of two patients in whom a permanent pacemaker was implanted before a diagnosis of epilepsy was established. Treatment with phenytoin or carbamazepine resulted in nearly complete resolution of symptoms in all five patients. Because pacemaker implantation does not prevent recurrent symptoms, but anticonvulsant therapy does, this experience underscores the importance of considering the diagnosis of partial epilepsy in selected patients with sinus bradyarrhythmias and syncope.



  • Case report describing five different patients who experienced syncope and were treated with permanent pacemaker installation. However despite normal function of these pacemakers, these patients still experienced syncope. Upon further testing patients were found to have abnormal electroencephalograms (consisting of the temporal lobe) and were put on AEDs. After treatment with AEDs, these patients experience less syncope events.


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