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ORIGINAL ARTICLE

Syncope, seizure or both?

, , &
Pages 31-34 | Received 23 Feb 2016, Accepted 05 Sep 2016, Published online: 21 Nov 2016
 

Abstract

Ictal asystole (IA) is a rare phenomenon in patients with seizures with an incidence of 0.27–0.4% and has been proposed as a possible mechanism of sudden unexpected death in epilepsy patients (SUDEP). We present a case of a 53-year-old woman who initially presented with episodes of expressive aphasia and was treated with antiepileptic drugs (AEDs). While on therapy she experienced episodes of syncope. During her hospitalization for tapering of AEDs and 24-hour EEG monitoring, the patient developed a seizure followed by sinus bradycardia and an 18-second sinus pause, resulting in loss of consciousness and slowing of cerebral activity. Ten seconds after the return of cardiac activity, the EEG showed return of cerebral activity. A dual chamber pacemaker was implanted.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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