Ictal asystole and eating reflex seizures with temporal lobe epilepsy

Both ictal asystole and eating reflex seizures are rare conditions that are closely related to temporal lobe epilepsy (TLE). Patients exhibiting these two conditions simultaneously have not been previously reported. We describe two unusual cases in which patients with left TLE were confirmed to have ictal asystole and eating epilepsy by video-electroencephalographic monitoring. As the pathophysiological mechanisms underlying these conditions are unknown, the association between ictal asystole and eating reflex seizures may be coincidental or may suggest an elusive common mechanism in association with TLE. In addition, combined electrocardiography monitoring and cardiac evaluation are recommended for patients with TLE and unexplained collapse.