Epileptic Disorders - Editor's Choice
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Ictal asystole mimicking seizure deterioration in temporal lobe epilepsy
Invited Editorial Comment by John B.P. Stephenson
Ictal asystole means cardiac standstill during an epileptic seizure, as in the woman described by Guldiken et al., (2015) in this issue. If the asystole lasts long enough more than 6 seconds then a syncope results (Bestawros et al., 2015). This is a situation in which a patient with definite epilepsy might need a cardiac pacemaker, but only after careful thought (Benditt et al., 2015).
Much more common is the scenario in which a patient is treated for “epilepsy” but instead has non-epileptic reflex syncope with or without cardiac asystole (Stephenson, 1990; Petkar et al., 2012).
It seems worthwhile to discuss how one should make one or other diagnosis, how one should treat, and especially whether a cardiac pacemaker might be indicated. Read full commentary