Cardiac arrhythmias occurring in association with epileptic seizures are a potential source of diagnostic confusion and a possible cause of sudden unexpected death in epilepsy. A case is described in which simultaneous ambulatory electroencephalography and electrocardiography revealed periods of asystole coinciding with epileptic seizures. The aystole appeared to precede obvious changes in the scalp recorded electroencephalogram (EEG), but clinical attacks and EEG seizure activity were not altered by pacemaker correction of the cardiac arrhythmias.
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