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  • Title: Peri-ictal atrioventricular conduction block in a patient with a lesion in the left insula: case report and review of the literature.
    Author: Surges R, Scott CA, Walker MC.
    Journal: Epilepsy Behav; 2009 Oct; 16(2):347-9. PubMed ID: 19700372.
    Abstract:
    Seizure-induced syncope is uncommon and is usually due to peri-ictal bradycardia and asystole. In contrast, peri-ictal atrioventricular conduction block (AV block) has been reported only rarely. Here, we review the literature on peri-ictal AV block and describe a patient with recurrent episodes of epigastric auras that were occasionally followed by a sensation of dizziness and syncope because of transient third-degree AV block. After installation of a cardiac pacemaker, epigastric auras persisted, whereas the sensation of dizziness and syncope stopped. MRI revealed a lesion in the left insula, leading to the notion that recurrent syncope was most likely due to ictal activity in central autonomic networks.
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