Syncope: there is more than haemodynamic failure.

Convulsive syncopes may be particularly difficult to differentiate from epileptic seizures. Recurrent syncopes are caused by autonomic or non-autonomic failure. In this report, we present a 22-year-old woman who was misdiagnosed as epileptic and whose first symptoms during neurocardiogenic syncope occurred prior to asystole. The patient sensed her aura and reached for the alarm button 2 s before a cardiac asystole was documented in the ECG. We conclude that so far unspecified autonomic mechanisms play a significant role in our patient leading to the symptoms of dizziness and nausea heralding her attacks prior to the occurrence of asystole.