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Ictal asystole mimicking seizure deterioration in temporal lobe epilepsy
Authors:Baburhan Guldiken  Elisabeth Hartl  Jan Rémi  Soheyl Noachtar
Affiliation:1. Epilepsy Center, Department of Neurology, University of Munich, Munich, Germany;2. Department of Neurology, Medical Faculty of Trakya University, Edirne, Turkey
Abstract:We report on a patient with temporal lobe epilepsy, secondary to a left lateral temporal cavernoma, in whom the change in seizure semiology suggested recurrence of secondary generalized seizures. Anticonvulsive medication previously controlled secondary generalized seizures over a period of years but focal seizures continued at a lower rate. Continuous video‐EEG monitoring revealed ictal asystole associated with myoclonic syncope and falls during focal seizures arising from the left temporal lobe. After implantation of a cardiac pacemaker, no more falls occurred during the focal seizures. In conclusion, recurrence of seizure‐associated falls is typically attributed to recurrence of secondary generalized seizures, however, ictal asystole should be considered in selected epilepsy patients as a differential diagnosis of falls. Published with video sequence]
Keywords:ictal asystole  syncope  seizure‐associated fall
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