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Epileptic Disorders - Editor's Choice

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September, 2015

When patients with epilepsy or “epilepsy” might need a pacemaker  

Epileptic Disorders September 2015

Ictal asystole mimicking seizure deterioration in temporal lobe epilepsy
Clinical Commentary with video sequence
Baburhan Guldike, Elisabeth Hartl, Jan Rémi, Soheyl Noachtar
Epileptic Disorders 2015; 17 (3): 332-5

Invited Editorial Comment by John B.P. Stephenson
Cruachan, Bowmore, Isle of Islay, Scotland
Epileptic Disord 2015; 17 (3): 209-10

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

Clinical Commentary (pdf) | Clinical Commentary with Video Sequence


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