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伴有ST段抬高型心肌梗死的心律失常诱发的非癫痫性发作

Nonepileptic seizure provoked by cardiac dysrhythmia with STEMI.

作者信息

Pourmand A, Davis S, Yensen K

机构信息

Emergency Medicine Department, George Washington University School of Medicine and Health Sciences, Washington DC, United States.

Emergency Medicine Department, George Washington University School of Medicine and Health Sciences, Washington DC, United States.

出版信息

Am J Emerg Med. 2018 Jan;36(1):169.e1-169.e3. doi: 10.1016/j.ajem.2017.10.013. Epub 2017 Oct 7.

Abstract

Acute seizures represent 1% of all visits to emergency departments in the United States. While many acute seizures are correctly attributable to underlying epilepsy, approximately one-third of acute seizures are provoked by underlying and potentially life-threatening acute conditions. Many clinical syndromes associated with seizure-like activity are well-established and readily identified in the acute setting. Cardiac dysrhythmias are known causes of acute seizure-like activity and, if transient and not captured by electrocardiogram tracings during acute episodes, may be incorrectly diagnosed as epileptic seizures. We report a case of acute ST-segment elevation myocardial infarction presenting with acute symptomatic seizure due to occult transient cardiac dysrhythmia.

摘要

在美国,急性癫痫发作占急诊就诊病例的1%。虽然许多急性癫痫发作可正确归因于潜在的癫痫,但约三分之一的急性癫痫发作是由潜在的、可能危及生命的急性病症诱发的。许多与癫痫样活动相关的临床综合征已得到充分证实,在急性情况下很容易识别。心脏心律失常是急性癫痫样活动的已知病因,如果是短暂性的,且在急性发作期间未被心电图记录捕捉到,可能会被误诊为癫痫发作。我们报告一例急性ST段抬高型心肌梗死病例,该病例因隐匿性短暂性心脏心律失常而出现急性症状性癫痫发作。

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