Cardiac asystole masquerading as temporal lobe epilepsy
Ficker DM, Cascino GD, and Clements IP (1998) Cardiac asystole masquerading as temporal lobe epilepsy. Mayo Clin Proc 73:8 784–6.
Abstract: Episodic behavior associated with impairment of consciousness is a protean clinical manifestation that may suggest a wide range of medical or neurologic disorders. We describe a patient whose symptoms of an epigastric "aura" followed by loss of consciousness suggested temporal lobe epilepsy. The episodic behavior was refractory to antiepileptic drug therapy. Prolonged video-electroencephalographic monitoring confirmed that the clinical events were cardiogenic related to asystole. Antiepileptic drug therapy was discontinued, and a cardiac pacemaker was inserted. The clinical patterns that distinguish syncope from seizures and the importance of prolonged video-electroencephalographic monitoring are discussed.
Context
- Single-case report of 52 year old patient with aura and loss of consciousness. Episodes were refractory to multiple AED but were found to occur in association with asystole, and were resolved by insertion of a pacemaker. Of note, asystole was accompanied by focal slowing of the EEG.