Cardiac asystoles misdiagnosed as epileptic seizures. (27th January 2015)

• Record Type: Journal Article
• Authors: Chiesa, Valentina; Vignoli, Aglaia; Canevini, Maria Paola
• Is Part Of: BMJ case reports. Volume 2015
• Publication Date: 2015-01-27
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2014-206969
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : We report a case of a 78-year-old man who presented several episodes of transient loss of consciousness preceded by sensation of ascending heat from the feet, with increasing frequency and duration within a few weeks. One month later he was admitted because he started to fall during the episodes, which became daily. Brain MRI detected a gliotic right frontal area, and EEG showed slow activity in the same region. Carbamazepine was started without clinical response despite high plasmatic level. Video-EEG polygraphic monitoring was performed and the patient showed an episode of left hemifacial clonic jerks followed by loss of consciousness, starting 17 s after the beginning of asystole. Synus rhythm reappeared 32 s later and the patient regained consciousness in few seconds. A pacemaker was implanted and carbamazepine was withdrawn. No further episodes occurred.