A 65 year old woman had a 12 year history of frequent, recurrent seizure-li
ke episodes labelled as treatment resistant epilepsy after neurological eva
luation and follow up and treatment with multiple antiepileptic medications
. Carotid sinus massage provoked 5.6 seconds asystole with symptom reproduc
tion, and she has remained symptom-free after permanent pacemaker implantat
ion for her carotid sinus syndrome and withdrawal of antiepileptic medicati
ons.