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Question category: Neurology

A 64 year old gentleman with previous myocardial infarction and ischaemic heart disease presents with several episodes of collapse. He states that these episodes occur without warning and he has no presyncopal symptoms. Witnesses say that he turns pale then suddenly falls to the ground. He then flushes and regains consciousness. On a few occasions he has had a generalized tonic clonic seizure and has been confused for some time after this. Which of the following is the most likely diagnosis?

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