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.
Chuang
Wei-Yuan
WY
Cardiovascular Study Group, Institute of Medicine, Division of Cardiology, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung City, 402, Taiwan.
Chuang
Yao-Tsung
YT
Ueng
Kwo-Chang
KC
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