Abstract We describe four patients with a previous diagnosis of epilepsy. After reviewing the ECG during the video‐EEG recording, cardiogenic syncope, resulting from a cardiac arrhythmia, was identified as the cause of the seizures. Epileptic disorders and cardiogenic syncope may both manifest with convulsions, loss of consciousness, and loss of postural tone, leading to a high level of misdiagnosis. The one‐lead ECG during video‐EEG monitoring is a key component, which may allow correct diagnosis and treatment.