Abstract
Some forms of focal epilepsy, including temporal lobe epilepsy, are rarely associated with ictal bradycardia and sinus node arrest. We report a case of a previously healthy man presenting with syncope in whom telemetry revealed sinus arrest. Initial treatment was with permanent pacemaker implantation and it was only following a subsequent grand mal seizure that other symptoms suggestive of temporal lobe epilepsy were documented. Anti-epileptic medication was subsequently commenced with resolution of all symptoms. There are few previously reported cases of syncope and documented sinus node arrest as the presenting feature of temporal lobe epilepsy.
[download-attachments container="div" style="list" display_icon="1" display_count="1" display__size="0"]
References
- Misdiagnosis of epilepsy: many seizure-like attacks have a cardiovascular cause. Zaidi A, Clough P, Cooper P, Scheepers B, Fitzpatrick AP. J Am Coll Cardiol. 2000 Jul;36(1):181-4
- Bradycardia and asystole induced by partial seizures: a case report and literature review. Devinsky O, Pacia S, Tatambhotla G. Neurology. 1997 Jun;48(6):1712-4
- Cardiac arrhythmias in focal epilepsy: a prospective long-term study. Rugg-Gunn F, Simister R, Squirrell M, et al. Lancet 2004;364:2212-2219
- Seizure induced cardiac asystole in epilepsy patients undergoing long term video-EEG monitoring. Lanz M, Oehl B, Brandt A, et al. Seizure. 2011 Mar;20(2):167-172
- Cardiovascular effects of human insular cortex stimulation. Oppenheimer SM, Gelb A, Girvin JP, et al. Neurology 1992;42(9):1727-32
- Heart obeys the brain: seizure ceases cardiac rhythm. Wolber T, Namdar M, Duru F. Pacing Clin Electrophysiol. 2010 Aug;33(8):e72-5
- 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: The Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Brignole M, Auricchio A, BaronEsquivias G, et al. Europace 2013 Aug; 15(8): 1070-1118
Request Permissions
To request copyright permission to republish or share portions of our works, please visit Copyright Clearance Center’s (CCC) Marketplace website by clicking the button below:
