title: A case of being scared to death.
abstract: A 21-year-old student had generalized tonic-clonic seizures induced by the mental image of human pain. One ictal event occurred while he was listening to a description of suffering, as read from Fox's Book of Martyrs. While again listening to the offending passage during EEG and ECG monitoring, he had 25 s of asystole terminating in electrocerebral silence and a generalized tonic, tonic-clonic seizure. A 24-hour ambulatory monitor recorded episodes of progressive sinus bradycardia concomitant with PR-interval prolongation and Wenckebach atrioventricular block. Sinoatrial conduction times and sinus node recovery times were normal on atrial pacing. Since implantation of a permanent pacemaker, he has been asymptomatic. This patient demonstrates the advantages of reproducing the circumstances associated with an unexplained loss of consciousness while monitoring the EEG and ECG.
mesh_terms: D000328:Adult; D005239:Fear; D006212:Hallucinations / Q000150:complications; D006801:Humans; D008297:Male; D010146:Pain / Q000150:complications*; D012640:Seizures / Q000209:etiology*; D014474:Unconsciousness / Q000209:etiology