Brain seizes, heart ceases: a case of ictal asystole.

Epileptic seizures commonly result in changes of cardiac rate. Although tachycardias are much more frequent, ictal bradycardia and asystole may be life threatening and contribute to the syndrome of sudden unexplained death in epileptic patients. DiVerentiation between primary cardiac and cerebrogenic bradyarrhythmia is possible with the use of simultaneous EEG and ECG recording. The correct identification of ictal bradycardia and asystole is important as treatment needs to consider both optimal anticonvulsant therapy and the implantation of a cardiac demand pacemaker. We report ictal asystole in a patient with a left temporal lobe seizure identified by simultaneous ECG and scalp EEG recording.