Should every patient who presents with a seizure have an electrocardiogram?

Iralde, Gustavo R.; Arazi, Hernán Cohen; Waldman, Silvina V.; Abello, Maurício; Doiny, David; Spampinatto, Ricardo; Russo, Mario Salvatore; Pensa, Claudio; Grancelli, Hugo

doi:10.1016/j.ajem.2008.08.010

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…A detailed medical history is important to rule out arrhythmogenic syncope in patients with seizure. Our patient complained of chest pain before every seizure episode; this can be a sign of syncope due to cardiac causes 3 . However, his symptoms, which also included postictal confusion, can be mistaken for those of epilepsy 4 .…”

Section: Discussionmentioning

confidence: 74%

“…Our patient complained of chest pain before every seizure episode; this can be a sign of syncope due to cardiac causes. 3 However, his symptoms, which also included postictal confusion, can be mistaken for those of epilepsy. 4 In addition, our patient was diagnosed with long QT syndrome type 2 (LQT2), which is more often misdiagnosed than long QT syndrome type 1 (LQT1) because it occurs at night or when the patient is resting.…”

Section: Discussionmentioning

confidence: 99%

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Delayed diagnosis of long QT syndrome in a patient with seizures

Shin

Hong

Lee

2019

Hong Kong Journal of Emergency Medicine

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Introduction: Long QT syndrome accompanied by a seizure episode is often misdiagnosed as primary epilepsy. Although patients with Long QT syndrome who are misdiagnosed and improperly managed are likely to result in fatality, their first clinical manifestations are seizure episodes in many cases. Case presentation: A 17-year-old boy visited the emergency department with poorly controlled seizure during epilepsy treatment was found to have been misdiagnosed with epilepsy when he was 7 years old. His electrocardiography showed a prolonged QT interval. After careful re-evaluation, he was finally diagnosed with Long QT syndrome and recovered without any seizure episodes in the absence of anti-epileptic agents. Discussion and conclusion: Careful initial assessment including repetitive electrocardiography, when abnormal, is required for those who visit the emergency department with a seizure or who show no definite abnormalities in diagnostic work up process.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Delayed diagnosis of long QT syndrome in a patient with seizures

Shin

Hong

Lee

2019

Hong Kong Journal of Emergency Medicine

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“…5 However, some international guidelines recommend that physicians consider obtaining an ECG in children when there is diagnostic uncertainty regarding epilepsy. 7 Clinicians should be aware that children presenting with a seizure and a normal electroencephalogram, syncope with exercise, or a family history of sudden death are at risk for delayed diagnosis of long QT syndrome. 7 Clinicians should be aware that children presenting with a seizure and a normal electroencephalogram, syncope with exercise, or a family history of sudden death are at risk for delayed diagnosis of long QT syndrome.…”

Section: Commentary Bymentioning

confidence: 99%