title: Ictal asystole: an indication for pacemaker implantation and emerging cause of sudden death.
abstract: Ictal asystole is being recognized as a potential mechanism of sudden unexplained death in epilepsy (SUDEP). We report a case of a patient without known cardiac disease presenting with ictal asystole resulting in syncope, trauma, and need for pacemaker implantation. The management of ictal asystole is also briefly reviewed. This case is notable for the asystolic episode wholly captured on video-electroencephalogram/electrocardiogram, the serious risk of trauma and death posed to the patient, and its implications for the mechanism of ictal asystole. This report will alert physicians to the possibility of ictal arrhythmias as a cause of syncope and SUDEP in vulnerable patients.
authors.affiliation: Pediatric Residency Program, University of Washington, Seattle, Washington 98195, USA.
authors.forename: Samuel G
authors.initials: SG
authors.lastname: Wittekind
authors.forename: Octavian
authors.initials: O
authors.lastname: Lie
authors.forename: Stephen
authors.initials: S
authors.lastname: Hubbard
authors.forename: Mohan N
authors.initials: MN
authors.lastname: Viswanathan
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology* / Q000517:prevention & control*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004827:Epilepsy / Q000150:complications* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D016896:Treatment Outcome