The neuroimaging evidence regarding the physiological role of temporal lobe in regulating the peripheral autonomic response are rapidly replicating. However, the role of temporal cortical damage in the generation of cardiac arrhythmias are unclear. Here, we describe a unique case of isolated, small, right temporal infarct presented with significant transient autonomic symptoms. Our case helps to clarify an ongoing debate on the relationship between lesion temporal cortical location and the occurrence of cardiac arrhythmias in stroke patients and also suggest that nonspecific cardiological symptoms should be evaluated with detailed cardiological workout in stroke patients who are presented with normal ECG. To the best of our knowledge, isolated temporal infarct have not been previously reported to be associated with the occurrence of cardiac arrhythmias in stroke patients.