Temporal lobe epilepsy and postural orthostatic tachycardia syndrome (POTS)

Abstract

We describe a 20-year-old woman suffering from right temporal epilepsy, behavioral disorder, and a complaint of paroxysmal palpitations accompanied by anxiety. Detailed cardiac evaluation revealed that the palpitations were due to episodes of marked sinus tachycardia secondary to a concomitant postural orthostatic tachycardia syndrome (POTS) and not of psychogenic origin as initially thought. Treatment with a beta-blocker resulted in the disappearance of palpitations and the associated anxiety. This is the first report of the coexistence of partial epilepsy and POTS. The recognition of such a syndrome in epileptic patients is important in order to offer appropriate therapy. Ó

Postural tachycardia syndrome with asystole on head-up tilt

“…In fact, prior to the HUT evaluation, two of our patients were thought to have epilepsy and therefore treated with antiepileptic medications. Despite the coexistence of POTS and temporal lobe epilepsy has been previously reported [15], we did not believe any of our patients had bona fide epilepsy disorder. EEG monitoring during the HUT may help to define the semiology of the convulsive syncope.…”