Syncope—Brain or Heart? A Case Report


Address for reprints: Håkan Nilsson. M.D., Department of Neurology. Malmö General Hospital, S-214 01 Malmö, Sweden.


A 44-year-old man suffered from recurrent episodes of unconsciousness, without any other concomitant manifestations. After routine ivorkup, EEC and CT had proven nondiagnostic, prolonged Holter monitoring revealed a single episode of asystole, lasting 7.6 seconds. A pacemaker was inserted but did not abolish his episodic syncope. Subsequently, long-lerm EEC recording revealed epileptiform activity with independent foci in both temporal Jobes. Antiepilepfic treatment relieved the patient of his symptoms. This case illustrates the intimate relationship between the heart and the brain that sometimes lies behind syncope.