Seizure Triggered by Sick Sinus Syndrome

Area of Science:

• Cardiology
• Neurology

Background:

• Sick sinus syndrome (SSS) is a sinoatrial node dysfunction causing bradycardia and potential hypoperfusion.
• Seizures are an exceptionally rare presentation of SSS.

Observation:

• A 69-year-old male experienced generalized tonic-clonic seizures, with normal MRI and EEG findings.
• During emergency room evaluation, presyncope coincided with bradycardia and sinus pauses.

Findings:

• Atropine and dopamine stabilized the patient, followed by successful permanent pacemaker implantation.
• This intervention led to complete resolution of seizure symptoms.

Implications:

• This case highlights SSS as a rare but critical cause of seizures, distinct from convulsive syncope or ictal bradycardia.
• Prompt diagnosis and treatment with a pacemaker can effectively manage SSS-induced seizures.