Hunt D P J, Tang K
The Hammersmith Hospital NHS Trust, London, UK.
Emerg Med J. 2005 Aug;22(8):600-1. doi: 10.1136/emj.2003.007997.
A 50 year old woman with a previous diagnosis of epilepsy presented to the emergency department with a generalised seizure. Her admission ECG showed QT prolongation secondary to bradycardia and a subsequent seizure in the department demonstrated that these events were secondary to cerebral hypoperfusion during episodes of torsades de pointes. This case illustrates how long QT syndrome can masquerade convincingly as epilepsy, delaying treatment and exposing the patient to a high risk of sudden cardiac death. Careful ECG analysis is recommended for all patients presenting with seizures.
一名先前被诊断为癫痫的50岁女性因全身性癫痫发作被送往急诊科。她入院时的心电图显示因心动过缓继发QT间期延长,随后在科室发生的一次癫痫发作表明,这些事件继发于尖端扭转型室速发作时的脑灌注不足。该病例说明了长QT综合征如何能令人信服地伪装成癫痫,延误治疗并使患者面临心脏性猝死的高风险。建议对所有癫痫发作的患者进行仔细的心电图分析。