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Cardiac asystole masquerading as temporal lobe epilepsy
D M Ficker1, G D Cascino, I P Clements
1Department of Neurology, Mayo Clinic Rochester, Minnesota 55905, USA.
Mayo Clinic Proceedings
|August 14, 1998
Summary
Episodic loss of consciousness mimicking epilepsy was found to be caused by cardiac asystole. Pacemaker insertion resolved the symptoms, highlighting the importance of differentiating syncope from seizures.
Area of Science:
- Neurology
- Cardiology
- Clinical Medicine
Background:
- Episodic impairment of consciousness presents a diagnostic challenge, potentially indicating diverse neurological or medical conditions.
- Distinguishing between seizures and syncope is crucial for appropriate patient management.
Observation:
- A patient presented with an epigastric aura followed by loss of consciousness, initially suspected as temporal lobe epilepsy.
- Symptoms were unresponsive to standard antiepileptic drug therapy.
Findings:
- Prolonged video-electroencephalographic monitoring revealed the events were cardiogenic, specifically due to asystole.
- Discontinuation of antiepileptic drugs and pacemaker implantation successfully resolved the patient's episodes.
Implications:
- This case underscores the necessity of considering cardiogenic causes, particularly cardiac asystole, in episodic consciousness impairment.
- Prolonged video-electroencephalographic monitoring is vital for accurate diagnosis when differentiating syncope from seizures.