Complete atrioventricular block during temporal epilepsy: A case report.

The authors report the case of a 37 year old woman with no previous medical history, admitted to hospital for investigation of unexplained syncope, so metimes associated with generalised fits. After standard non-invasive cardiovascular investigations, no diagnosis cou ld be made. The tilt test induced a minor syncopal episode without reproduc ing the clinical symptoms. In view of the discordance between the induced a nd spontaneous symptoms, a neurological opinion was requested. During the r ecording of an electroencephalogram, syncopal atrioventricular block was ob served, preceded by auditory hallucinations, reproducing exactly the clinic al symptoms. Analysis of the sequence of events showed the conduction defect to arise af ter the onset of the epileptic fit, indicating a diagnosis of syncopal comp lete atrioventricular block complicating cryptogenic temporal epilepsy, and requiring specific treatment. This case illustrates the importance of dose collaboration between cardiologists and neurologists in the management of cases of unexplained syncope.