Cardiogenic seizure with bradyarrhythmia: documentation of the mechanism during asystole

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Mendes LA and Davidoff R (1993) Cardiogenic seizure with bradyarrhythmia: documentation of the mechanism during asystole. Am Heart J 125:6 1786–8.

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First Paragraph: Cardiac syncope is a potentially a life-threatening problem in which an inadequate cardiac output results in sudden interruption of cerebral perfusion and loss of consciousness. Various neurologic disturbances may be associated with the unconscious period including motor twitches, tonic-clonic jerks and, rarely, frank convulsions, making the differentiation between syncope of cardiac origin and epilepsy potentially difficult. Failure to distinguish between these two disorders may result in inappropriate therapy and harm to the patient. The following report of an elderly woman with recurrent seizures illustrates the importance of establishing the cause of new-onset seizures in adults, especially elderly patients. Although it is widely believed that profound bradycardia may precipitate seizures, the mechanism has never been clearly documented. It is presumed that severe hypotension causescerebral anoxia with resultant triggering of a seizure focus. This is the first such case to demonstrate the mechanism of seizure

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