Cardiac asystole masquerading as temporal lobe epilepsy.
Episodic behavior associated with impairment of consciousness is a protean clinical manifestation that may suggest a wide range of medical or neurologic disorders. We describe a patient whose symptoms of an epigastric "aura" followed by loss of consciousness suggested temporal lobe epilepsy. The episodic behavior was refractory to antiepileptic drug therapy. Prolonged video-electroencephalographic monitoring confirmed that the clinical events were cardiogenic related to asystole. Antiepileptic drug therapy was discontinued, and a cardiac pacemaker was inserted. The clinical patterns that distinguish syncope from seizures and the importance of prolonged video-electroencephalographic monitoring are discussed.
Ficker
D M
DM
Department of Neurology, Mayo Clinic Rochester, Minnesota 55905, USA.
Cascino
G D
GD
Clements
I P
IP
D003937:Diagnosis, Differential; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000503:physiopathology; D006323:Heart Arrest / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013575:Syncope / Q000175:diagnosis* / Q000503:physiopathology