I have seen only rare cases of it. They all had tonic-clonic seizures triggered by profound bradycardia (sinus as well as AV block). In turn, the bradyarrhythmia was triggered by EEG-documented temporal lobe absence seizures. They all resolved long-term with pacing. Regardless of the underlying etiology, irreversible bradycardia causing syncope or near-syncope would trigger a pacemaker implant. Given one cannot be certain anti-epileptics will prevent all recurrences, the arrhythmia ...
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Agree with Dr. @Dr. First Last on the need for pacing in these cases, but I have seen several cases of focal impaired awareness seizures (presumably temporal lobe onset), which have caused bradyarrhythmia and asystole, requiring a pacemaker. One recent memorable patient described a typical temporal lobe aura, but then his wife would describe him as "looking dead" for 20-30 seconds without convulsive activity. In the EMU, he was shown to have asystole for up to 20 seconds as a result of a focal o...
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