Burghaus L, Liu W, Eggers C, Müller-Ehmsen J, Fink G R
Klinik und Poliklinik für Neurologie, Uniklinik Köln, Kerpener Strasse 62, Köln.
Fortschr Neurol Psychiatr. 2010 Jul;78(7):419-24. doi: 10.1055/s-0029-1245443. Epub 2010 Jun 8.
Syncope is a common and difficult differential diagnosis for epilepsy. One possible cause for a cardiac syncope is a long QT syndrome (LQTS). LQTS with torsade de pointes tachycardia can lead to lethal ventricular fibrillation and cardiac arrest. Patients with LQTS when first diagnosed as suffering from epileptic fits often experience a particularly long diagnostic delay which may even take years. In some cases, the diagnosis of LQTS is not made until the patient needs resuscitation due to a cardiac arrest. Therefore, ECG recording should be performed for every patient presenting with a seizure considered to be of epileptic origin not only at the beginning of the disease but also when fits occur in spite of antiepileptic treatment in order to prevent an incorrect diagnosis and delay in making the correct diagnosis.
晕厥是癫痫常见且难以鉴别的诊断。心脏性晕厥的一个可能原因是长QT综合征(LQTS)。伴有尖端扭转型室性心动过速的LQTS可导致致命的心室颤动和心脏骤停。首次被诊断为癫痫发作的LQTS患者通常会经历特别长的诊断延迟,甚至可能长达数年。在某些情况下,直到患者因心脏骤停需要复苏时才会诊断出LQTS。因此,对于每一位出现被认为是癫痫源性发作的患者,不仅在疾病初期,而且在尽管进行了抗癫痫治疗仍有发作时,都应进行心电图记录,以防止误诊和延误正确诊断。