Ictal syncope is a rare phenomenon that occurs in association with 0.002-0.4% of seizures. In the absence of other symptoms, seizures presenting with syncope may be challenging to diagnose. We report a case of a previously healthy male who developed recurrent episodes of syncope with postictal confusion and was later diagnosed with temporal seizures. The patient was successfully treated with anti-seizure drugs and placement of a cardiac pacemaker. In a systematic review of literature, we summarize the clinical characteristics of patients with ictal asystole and isolated syncope. Seizures should be considered in patients with syncope of uncertain etiology.
Keywords: AT, anterior temporal; Asystole; EEG, electroencephalographic; EKG, electrocardiogram; EMU, epilepsy monitoring unit; F, frontal; FT, fronto-temporal; Focal seizures; Ictal bradycardia; Ictal syncope; LEV, levetiracetam; MRI, magnetic resonance imaging; MT, medial temporal; OXC, oxcarbazepine; PT, parietal–temporal; SUDEP, sudden unexpected death in epilepsy; T, temporal; Temporal lobe epilepsy; VPA, valproic acid.