Peri-ictal atrioventricular conduction block in a patient with a lesion in the left insula: case report and review of the literature.
Seizure-induced syncope is uncommon and is usually due to peri-ictal bradycardia and asystole. In contrast, peri-ictal atrioventricular conduction block (AV block) has been reported only rarely. Here, we review the literature on peri-ictal AV block and describe a patient with recurrent episodes of epigastric auras that were occasionally followed by a sensation of dizziness and syncope because of transient third-degree AV block. After installation of a cardiac pacemaker, epigastric auras persisted, whereas the sensation of dizziness and syncope stopped. MRI revealed a lesion in the left insula, leading to the notion that recurrent syncope was most likely due to ictal activity in central autonomic networks.
Surges
Rainer
R
Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, UK.
Scott
Catherine A
CA
Walker
Matthew C
MC
D054537:Atrioventricular Block / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D002540:Cerebral Cortex / Q000473:pathology; D004244:Dizziness / Q000150:complications / Q000209:etiology; D004827:Epilepsy / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects; D013575:Syncope / Q000150:complications* / Q000209:etiology*