Idiopathic cardiac asystole presenting as an intractable adult onset partial seizure disorder

Asystole can occur during partial seizures. Conversely, asystole may produc e clinical features associated semiologically with partial or secondarily g eneralized tonic-clonic seizures. Management is so profoundly different tha t accurate diagnosis is critical. We performed simultaneous scalp video ele ctroencephalographic (EEG) and electrocardiographic (ECG) recordings in thr ee patients who presented with an intractable seizure disorder. Habitual ev ents were captured and reviewed. These revealed similar clinical features a nd temporal association with the ECG and EEG findings. Idiopathic asystole was detected as the cause in all three. All underwent emergency cardiac pac emaker implantation with resultant cessation of their paroxysmal episodes. If this diagnostic study had been delayed or not performed, all of our pati ents could have presented as sudden unexpected death in epilepsy (SUDEP). E arly video-EEG and ECG monitoring is essential in adults with intractable s eizure disorders. (C) 2001 BEA Trading Ltd.