title: Ictal asystole mimicking seizure deterioration in temporal lobe epilepsy.
abstract: We report on a patient with temporal lobe epilepsy, secondary to a left lateral temporal cavernoma, in whom the change in seizure semiology suggested recurrence of secondary generalized seizures. Anticonvulsive medication previously controlled secondary generalized seizures over a period of years but focal seizures continued at a lower rate. Continuous video-EEG monitoring revealed ictal asystole associated with myoclonic syncope and falls during focal seizures arising from the left temporal lobe. After implantation of a cardiac pacemaker, no more falls occurred during the focal seizures. In conclusion, recurrence of seizure-associated falls is typically attributed to recurrence of secondary generalized seizures, however, ictal asystole should be considered in selected epilepsy patients as a differential diagnosis of falls. [Published with video sequence].
authors.affiliation: Epilepsy Center, Department of Neurology, University of Munich, Munich, Germany, Department of Neurology, Medical Faculty of Trakya University, Edirne, Turkey.
authors.forename: Baburhan
authors.initials: B
authors.lastname: Guldiken
authors.affiliation: Epilepsy Center, Department of Neurology, University of Munich, Munich, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Hartl
authors.affiliation: Epilepsy Center, Department of Neurology, University of Munich, Munich, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Rémi
authors.affiliation: Epilepsy Center, Department of Neurology, University of Munich, Munich, Germany.
authors.forename: Soheyl
authors.initials: S
authors.lastname: Noachtar
mesh_terms: D000058:Accidental Falls; D004829:Epilepsy, Generalized / Q000503:physiopathology*; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology*; D005260:Female; D006323:Heart Arrest / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D009207:Myoclonus / Q000503:physiopathology*
keywords: ictal asystole; seizure-associated fall; syncope