John Libbey Eurotext

Epileptic Disorders

The Educational Journal of the

Ictal asystole mimicking seizure deterioration in temporal lobe epilepsy Volume 17, issue 3, September 2015


  • Ictal asystole mimicking seizure deterioration in temporal lobe epilepsy


  • Figure 1
1 Epilepsy Center,Department of Neurology, University of Munich, Munich, Germany
2 Department of Neurology, Medical Faculty of Trakya University, Edirne, Turkey
* Correspondence: Soheyl Noachtar Epilepsy Center, Dept. of Neurology, University of Munich, Marchioninistr. 15, D-81377 Munich, Germany
  • Key words: ictal asystole, syncope, seizure-associated fall
  • DOI : 10.1684/epd.2015.0758
  • Page(s) : 332-5
  • Published in: 2015

We report on a patient with temporal lobe epilepsy, secondary to a left lateral temporal cavernoma, in whom the change in seizure semiology suggested recurrence of secondary generalized seizures. Anticonvulsive medication previously controlled secondary generalized seizures over a period of years but focal seizures continued at a lower rate. Continuous video-EEG monitoring revealed ictal asystole associated with myoclonic syncope and falls during focal seizures arising from the left temporal lobe. After implantation of a cardiac pacemaker, no more falls occurred during the focal seizures. In conclusion, recurrence of seizure-associated falls is typically attributed to recurrence of secondary generalized seizures, however, ictal asystole should be considered in selected epilepsy patients as a differential diagnosis of falls. [Published with video sequence]