Ictal asystole: A benign condition?

Stephan U. Schuele*, Adriana C. Bermeo, Eduardo Locatelli, Richard C. Burgess, Hans O. Lüders

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

79 Scopus citations


Ictal asystole (IA) has been implicated as a preventable cause of sudden unexplained death in epilepsy presumably provoked by a direct autonomic effect of the electrical stimulus on the heart. An electronic database search of patients with IA was performed comparing heart rate (HR) characteristics to a group of patients with vasovagal asystole. IA was seen in eight patients, all with temporal lobe epilepsy. No statistical difference was found in duration of asystole, bradycardia, and baseline HR characteristics except of a higher HR acceleration postasystole in the controls. None of the six patients with IA who underwent pacemaker implantation had recurrence of asystolic events during mean follow-up of 5 years. This study in a small group of patients suggests that the epileptic activation leading to IA is possibly mediated through a transient increase in vagal tone and not by a direct autonomic effect on the heart.

Original languageEnglish (US)
Pages (from-to)168-171
Number of pages4
Issue number1
StatePublished - Jan 2008


  • Ictal asystole
  • Sudden unexplained death in epilepsy
  • Syncope

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology


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