Life and death diagnosis

Chadwick, David; Jelen, Paddy; Almond, Solomon

doi:10.1136/jnnp.2010.211672

Cited by 8 publications

(6 citation statements)

References 8 publications

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“…This case has many parallels to a case of sudden death from long QT syndrome reported in Practical Neurology in 20105; at that time, the authors recommended 12-lead ECG in all people with a diagnosis of epilepsy, having an EEG record a channel of ECG with reporting of QT and QTc interval, and to ensure there are local arrangements for joint working with cardiology. In this case, clearly a review of the ECG channel of her EEG initially might have prompted a 12-lead ECG and cardiac investigations.…”

Section: Discussionmentioning

confidence: 85%

Long QT syndrome masquerading as epilepsy

et al. 2018

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The diagnosis of epilepsy is incorrect in up to 20% of cases so should be revisited if attacks are not responding to treatment. We present a case of long QT syndrome that remained undiagnosed in the epilepsy clinic for 15 years until a near-fatal arrhythmia revealed the diagnosis and allowed effective treatment of her attacks. We hope this near miss raises awareness of long QT syndrome as a potentially fatal, rare but treatable condition that neurologists must consider in people with a label of refractory epilepsy. We provide practical pointers to increase the chance of early diagnosis and explore the impact of a late diagnosis for the patient and her family.

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Section: Discussionmentioning

confidence: 85%

Long QT syndrome masquerading as epilepsy

et al. 2018

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“…Even in expert hands, however, spotting QT abnormalities is problematic, most cardiologists miss them, and IER is costly . It is important that all those who care for people with epilepsy be aware that not only might potentially life‐threatening cardiac disorders mimic epilepsy, but also patients with epilepsy might be at increased risk of concurrent cardiac arrhythmias.…”

Section: Discussionmentioning

confidence: 99%

Sudden unexpected death in epilepsy genetics: Molecular diagnostics and prevention

et al. 2016

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Summary Epidemiologic studies clearly document the public health burden of sudden unexpected death in epilepsy (SUDEP). Clinical and experimental studies have uncovered dynamic cardiorespiratory dysfunction, both interictally and at the time of sudden death due to epilepsy. Genetic analyses in humans and in model systems have facilitated our current molecular understanding of SUDEP. Many discoveries have been informed by progress in the field of sudden cardiac death and sudden infant death syndrome. It is becoming apparent that SUDEP genomic complexity parallels that of sudden cardiac death, and that there is a pauci1ty of analytically useful postmortem material. Because many challenges remain, future progress in SUDEP research, molecular diagnostics, and prevention rests in international, collaborative, and transdisciplinary dialogue in human and experimental translational research of sudden death.

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“…These conditions, although rare, represent the greatest diagnostic challenge to the clinician dealing with epilepsy; patients are young, often with no symptoms other than syncope (without warning) and may have prominent myoclonic jerks during the T‐LOC. The central dilemma is that when they present mimicking a “first fit,” the second symptom may be sudden death (Chadwick et al., 2010). Ion channel mutations underlie the clinical manifestations, and most can be detected on a standard 12‐lead ECG (Marban, 2002; Kaufman, 2009).…”

Section: Underlying Causesmentioning

confidence: 99%

Cardiac syncope

Anderson

O’Callaghan

2012

Epilepsia

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Summary Clinicians who diagnose and manage epilepsy frequently encounter diagnoses of a nonneurological nature, particularly when assessing patients with transient loss of consciousness (T‐LOC). Among these, and perhaps the most important, is cardiac syncope. As a group, patients with cardiac syncope have the highest likelihood of subsequent sudden death, and yet, unlike sudden unexpected death in epilepsy (SUDEP) for example, it is the norm for these tragic occurrences to be both easily predictable and preventable. In the 12 months following initial presentation with cardiac syncope, sudden death has been found to be 6 times more common than in those with noncardiac syncope (N Engl J Med 309, 1983, 197). In short, for every patient seen with T‐LOC, two fundamental aims of the consultation are to assess the likelihood of cardiac syncope as the cause, and to estimate the risk of future sudden death for the individual. This article aims to outline for the noncardiologist how to recognize cardiac syncope, how to tell it apart from more benign cardiovascular forms of syncope as well as from seizures and epilepsy, and what can be done to predict and prevent sudden death in these patients. This is achieved through the assessment triad of a clinical history and examination, risk stratification, and 12‐lead electrocardiography (ECG).

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Life and death diagnosis

Cited by 8 publications

References 8 publications

Long QT syndrome masquerading as epilepsy

Long QT syndrome masquerading as epilepsy

Sudden unexpected death in epilepsy genetics: Molecular diagnostics and prevention

Cardiac syncope

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