Bradycardia, an epileptic ictal manifestation

Two patients with recurrent paroxysmal cardio-vascular symptoms are described. The first, an adult, suffered from syncopal events which did not respond to carbamazepine treatment and had a normal interictal EEG and ECG. The second, a child, presented with attacks of cyanosis, apnoea, and non-responsiveness in clusters, with normal interictal examinations. In both patients, prolonged simultaneous EEG and ECG monitoring demonstrated ictal bradycardia accompanied by paroxysmal discharges in the left temporal area.