Temporal lobe seizures triggering recurrent syncope by ictal asystole.

Described here is a case of a patient with left temporal lobe epilepsy and recurrent complex partial seizures associated with asystole. The posturing and myoclonus caused by the nonepileptogenic syncope during the asystole gave the appearance of secondary generalization prompting a surgical evaluation. A distinct atonic phase that interrupts the transition from a complex partial semiology to generalization is a critical clue to the presence of ictal asystole and is easily detected by video/EEG monitoring.