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G307(P) Seizure mimicry
  1. A Gajdošová,
  2. S Khanová,
  3. B Šolty sová
  1. Paediatric Department, Nemocnica Poprad, a.s., Poprad, Slovakia

Abstract

Introduction Long QT syndrome is a congenital disorder characterised by a prolongation of QT on ECG and a propensity to ventricular tachyarrhythmias, which may lead to syncope, cardiac arrest or sudden death. Clinical presentation in patients with LQTS may mimic epilepsy.

Case report 9 years old boy was admitted to ourpediatric ward for recurrent tonic seizure with involuntary loss of bladder control in june 2016. Patient had previous history of similar episode in 2015, at that time EEG, sleep deprivation EEG and MRI brain scan were normal. Since then, patient was followed up by a paediatric neurologist without any pharmacotherapy. After the admission, treatment with antiepileptic drugs was immediately started, even when there were no abnormalities on repeated EEG. Inspite of the treatment, two more seizures were observed during the hospitalisation. The diagnosis of epilepsy was re-evaluated. ECG was performed, showing the evidence of prolonged QT interval. Patient was immediately transferred to paediatric cardiology centre and treatment with beta blockers was initiated. Due to the unresponsiveness to pharmacotherapy, patient under- went pacemaker implantation.

Conclusion This case report demonstrates the importance of performing ECG as a routine test in patients with seizures or epilepsy which does not respond to the antiepileptic medications. We would like to emphasise the importance of ECG knowledge as well as necessity of cardiac evaluation in every patient with seizure.

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