Fourteen-year follow-up in a teenager with congenital long QT syndrome masquerading as idiopathic generalized epilepsy.
Long QT syndrome is a potentially lethal cardiac channelopathy that can be mistaken for epilepsy in young people. We report a 17-year-old man who was initially treated as having both daytime and nocturnal idiopathic epilepsy for 5 years. A series of electrocardiograms showed the time of the convulsive episodes, and genetic testing lead to the final diagnosis. The combined use of a beta-blocker and a pacemaker implant incompletely abolished the torsade de pointes. After an additional near-fatal event, a cardioverter defibrillator was implanted as final bridge therapy. An electrocardiogram with the correct calculation of the QT interval should be performed on all young people with a suggestive history; that is, treat refractory convulsive episodes specifically with nondiagnostic electroencephalograms.
Cardiovascular Study Group, Institute of Medicine, Division of Cardiology, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung City, 402, Taiwan.
Wei-Yuan
WY
Chuang
Yao-Tsung
YT
Chuang
Kwo-Chang
KC
Ueng
D000293:Adolescent; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002304:Cardiac Pacing, Artificial / Q000379:methods; D017147:Defibrillators, Implantable; D003933:Diagnosis; D004232:Diuretics / Q000627:therapeutic use; D004562:Electrocardiography; D004569:Electroencephalography; D004829:Epilepsy, Generalized / Q000175:diagnosis* / Q000628:therapy; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy; D006801:Humans; D008133:Long QT Syndrome / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D011433:Propranolol / Q000627:therapeutic use; D013148:Spironolactone / Q000627:therapeutic use; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000628:therapy
D000889:Anti-Arrhythmia Agents; D004232:Diuretics; D013148:Spironolactone; D011433:Propranolol