Self-limiting symptomatic peri-ictal bradyarryhthmia due to junctional AV rhythm

We report an elderly man with chronic uncontrolled localization-related epilepsy on three AEDs, who developed in-hospital symptomatic bradyarrythmia due to junctional atrio-ventricular (AV) rhythm after an episode of generalized seizure during his hospital stay. On further evaluation, the cardiac enzymes were normal and 2D-echocardiogram showed mild left ventricular hypertrophy. Patient recovered from the same with supportive treatment within few hours. We emphasize on importance of prompt recognition of this event and its implication including one of the mechanism for sudden unexplained death in epilepsy.