title: Cardiac asystoles misdiagnosed as epileptic seizures.
abstract: We report a case of a 78-year-old man who presented several episodes of transient loss of consciousness preceded by sensation of ascending heat from the feet, with increasing frequency and duration within a few weeks. One month later he was admitted because he started to fall during the episodes, which became daily. Brain MRI detected a gliotic right frontal area, and EEG showed slow activity in the same region. Carbamazepine was started without clinical response despite high plasmatic level. Video-EEG polygraphic monitoring was performed and the patient showed an episode of left hemifacial clonic jerks followed by loss of consciousness, starting 17 s after the beginning of asystole. Synus rhythm reappeared 32 s later and the patient regained consciousness in few seconds. A pacemaker was implanted and carbamazepine was withdrawn. No further episodes occurred.
authors: Epilepsy Centre, San Paolo Hospital, Milan, Italy.
authors: Valentina
authors: V
authors: Chiesa
authors: Epilepsy Centre, San Paolo Hospital, Department of Health Sciences, University of Milan, Italy.
authors: Aglaia
authors: A
authors: Vignoli
authors: Epilepsy Centre, San Paolo Hospital, Department of Health Sciences, University of Milan, Italy.
authors: Maria Paola
authors: MP
authors: Canevini
mesh_terms: D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D002220:Carbamazepine / Q000627:therapeutic use; D003951:Diagnostic Errors; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis* / Q000188:drug therapy; D006323:Heart Arrest / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010138:Pacemaker, Artificial
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine
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