title: New onset left frontal lobe seizure presenting with ictal asystole.
abstract: Ictal asystole is a presumably rare but potentially fatal complication of seizures, most often of temporal lobe origin. It is believed that at least some cases of sudden unexplained death in epilepsy (SUDEP) might be triggered by ictal bradycardia or asystole. Current standard practice is to implant a permanent pacemaker in these patients to prevent syncope and/or death. However, emerging data suggests that effective medical or surgical treatment of epilepsy might be enough to prevent cardiac asystole, eliminating the need for permanent pacemaker placement. We describe a case of new onset left frontal lobe epilepsy in a young athletic patient who presented with near-syncopal episodes but whose comprehensive work-up revealed frequent events of ictal bradycardia and asystole. He responded well to monotherapy using oxcarbazepine, avoiding a permanent pacemaker.
authors.affiliation: Department of Medicine, Division of Cardiology, Georgetown University Hospital, Washington, DC 20007, USA.
authors.forename: Sean A
authors.initials: SA
authors.lastname: Enkiri
authors.forename: Forough
authors.initials: F
authors.lastname: Ghavami
authors.forename: Chinekwu
authors.initials: C
authors.lastname: Anyanwu
authors.forename: Zayd
authors.initials: Z
authors.lastname: Eldadah
authors.forename: Richard L
authors.initials: RL
authors.lastname: Morrissey
authors.forename: Gholam K
authors.initials: GK
authors.lastname: Motamedi
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001919:Bradycardia / Q000209:etiology; D002220:Carbamazepine / Q000031:analogs & derivatives / Q000627:therapeutic use; D004562:Electrocardiography; D004569:Electroencephalography; D005625:Frontal Lobe / Q000503:physiopathology*; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D008297:Male; D000078330:Oxcarbazepine; D012640:Seizures / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine; D000078330:Oxcarbazepine