Surges Rainer, Scott Catherine A, Walker Matthew C
Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, UK.
Epilepsy Behav. 2009 Oct;16(2):347-9. doi: 10.1016/j.yebeh.2009.07.036. Epub 2009 Aug 22.
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.
癫痫发作所致晕厥并不常见，通常是由发作期周围性心动过缓和心搏停止引起。相比之下，发作期房室传导阻滞（AV阻滞）仅有极少的报道。在此，我们回顾了有关发作期AV阻滞的文献，并描述了一名患者，该患者反复出现上腹部先兆症状，偶尔会因短暂性三度AV阻滞而出现头晕和晕厥感。植入心脏起搏器后，上腹部先兆症状持续存在，而头晕和晕厥感消失。磁共振成像（MRI）显示左侧岛叶有病变，这使人们认为反复晕厥很可能是由于中枢自主神经网络的发作期活动所致。
