Palpitations caused by a Seizure with Autonomic Features

Abstract

Palpitations are a common symptom of presentation in medical practice. They are usually caused by cardiac arrhythmias, psychiatric problems or other miscellaneous causes, such as anaemia or endocrine causes. They are rarely due to autonomic seizures. We report a 55-year-old woman who presented at Sultan Qaboos University Hospital, Oman, with recurrent episodes of palpitations. Her associated symptoms included breathlessness and excessive sweating, followed by a sensation of dizziness. During subsequent episodes, she experienced symptoms of rising abdominal pain followed by a loss of consciousness. Positive electroencephalogram findings, as well as the response of the symptoms to antiepileptic drugs, were strongly suggestive of temporal lobe epilepsy as the possible diagnosis. The fact that the cardiac investigations, performed during an interictal period, were unremarkable also supports the hypothesis that the palpitations were linked to seizures. Epilepsy should be considered as a differential diagnosis of palpitations, especially if the palpitations are episodic.