Salazar Serrano Guilherme, Dias de Oliveira Alexandre, Miotto Ramsés, Lin Katia, Loureiro Fialho Guilherme
Department of Internal Medicine, University Hospital (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.
Cardiology Division, Department of Internal Medicine, HU, UFSC, Florianópolis, SC, Brazil.
Epilepsy Behav Rep. 2024 Apr 18;26:100667. doi: 10.1016/j.ebr.2024.100667. eCollection 2024.
Epilepsy is one of the most common chronical neurological conditions affecting over 50 million people worldwide. In addition to the stigma and discrimination, individuals with epilepsy suffer from a nearly three-fold increased risk of premature death compared to the general population. Although these premature deaths occur due to multiple causes, sudden unexpected death in epilepsy (SUDEP) still challenges neurologists and clinicians dealing with individuals with epilepsy. Recently, an increased interest in cardiac outcomes related to acute seizures and chronic epilepsy resulted in the groundbreaking development of the "epileptic heart" concept, and sudden death in individuals with epilepsy, which is 4.5 times as frequent as SUDEP according to some observational data, has gained more attention. As we gather information and learn about possible comorbidities and consequences of seizures and/or chronic epilepsy, we present a clinical case of a young patient with an unusual association of epilepsy, the Gorlin Goltz syndrome, and a cardiac fibroma with Wolf-Parkinson-White (WPW), who had multiple aborted cardiac arrests. Diagnostic challenges and multiple possible causes of sudden cardiac death in this single patient report are discussed.
癫痫是全球最常见的慢性神经系统疾病之一,影响着超过5000万人。除了污名化和歧视外,癫痫患者过早死亡的风险比普通人群高出近三倍。尽管这些过早死亡是由多种原因导致的,但癫痫猝死(SUDEP)仍然是困扰处理癫痫患者的神经科医生和临床医生的难题。最近,人们对与急性发作和慢性癫痫相关的心脏结局越来越感兴趣,这促成了“癫痫性心脏”概念的突破性发展,并且癫痫患者的猝死(根据一些观察数据,其发生率是SUDEP的4.5倍)受到了更多关注。在我们收集信息并了解癫痫发作和/或慢性癫痫可能的合并症及后果时,我们呈现了一名年轻患者的临床病例,该患者患有癫痫、戈林-戈尔茨综合征以及伴有预激综合征(WPW)的心脏纤维瘤,且多次发生心脏骤停未遂。本文讨论了该单一患者报告中诊断面临的挑战以及心脏性猝死的多种可能原因。