Interictal epileptiform discharges and asystole

We describe a case of a patient with Lennox-Gastaut syndrome who had asystole and sinus bradycardia during interictal epileptiform abnormalities on EEG. Video-EEG/EKG monitoring prior to corpus callosotomy recorded consistent prolongation of the R-R interval on the EKG during bursts of epileptiform abnormalities (generalized paroxysmal fast activity), which became transiently more pronounced after surgery. These findings reveal that interictal epileptiform abnormalities may cause significant cardiac arrhythmias in some individuals.