Ictal bigeminy.

Seizures can influence cardiac autonomic function and cause abnormalities in the electrocardiogram (EKG). A case of stereotypical bigeminy during left temporal lobe seizures recorded in the epilepsy monitoring unit is presented. The mechanism is likely due to spread of the ictal discharge to primary visceromotor regions in the left insula (Island of Reil). This case illustrates the potential influence of ictal brain activity on cardiac electrophysiology.