Adversive seizure as a clinical manifestation of the atrioventricular block

Introduction Spontaneous and recurrent epileptic seizures are necessary diagnostic criteria for epilepsy. There exist, however, circumstances in which an epileptic seizure is provoked by incidents of a cardiac origin. Focal neurological signs and symptoms secondary to arrhythmia are quite common. However, an epileptic seizure as a manifestation of the third degree atrioventricular block exemplifies the very rare case of such a correlation. Aim To demonstrate this clinical situation and to point out to the need to differentiate the origin of seizures, verify diagnosis of epilepsy, and perform multi-channel neurophysiological diagnostics, extended by a basic ECG examination. Case study We present the case of a 79-year-old male patient who was admitted to the Clinical Department of Neurology due to recurrent incidents of conjugated eye and head movements to the left secondary to the third degree atrioventricular block. Results and discussion Diagnostic and therapeutic approach implemented for patients with epileptic seizures and cardiac arrhythmia are discussed in detail. Conclusions An interdisciplinary diagnostic approach, carefully conducted interview and an appropriate selection of additional examinations and tests are essential for a proper differential diagnosis of seizure-like incidents.