title: Pause for thought? Syncope and sinus arrest as the presenting feature of temporal lobe epilepsy.
abstract: Some forms of focal epilepsy, including temporal lobe epilepsy, are rarely associated with ictal bradycardia and sinus node arrest. We report a case of a previously healthy man presenting with syncope in whom telemetry revealed sinus arrest. Initial treatment was with permanent pacemaker implantation and it was only following a subsequent grand mal seizure that other symptoms suggestive of temporal lobe epilepsy were documented. Anti-epileptic medication was subsequently commenced with resolution of all symptoms. There are few previously reported cases of syncope and documented sinus node arrest as the presenting feature of temporal lobe epilepsy.
authors.affiliation: Department of Cardiology Milton Keynes NHS Foundation Trust, Standing Way, Eaglestone, Milton Keynes.
authors.forename: R S
authors.initials: RS
authors.lastname: Wijesurendra
authors.affiliation: Department of Cardiology Milton Keynes NHS Foundation Trust, Standing Way, Eaglestone, Milton Keynes.
authors.forename: M
authors.initials: M
authors.lastname: Carey
authors.affiliation: Department of Neurology Milton Keynes NHS Foundation Trust, Standing Way, Eaglestone, Milton Keynes.
authors.forename: R J
authors.initials: RJ
authors.lastname: Butterworth
authors.affiliation: Department of Cardiology Milton Keynes NHS Foundation Trust, Standing Way, Eaglestone, Milton Keynes.
authors.forename: R
authors.initials: R
authors.lastname: Khiani
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D002220:Carbamazepine / Q000627:therapeutic use; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D012640:Seizures / Q000188:drug therapy / Q000209:etiology; D054138:Sinus Arrest, Cardiac / Q000209:etiology* / Q000601:surgery; D013575:Syncope / Q000209:etiology* / Q000601:surgery; D013686:Telemetry
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine