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Fourteen-Year Follow-up in a Teenager with Congenital Long QT Syndrome Masquerading as Idiopathic Generalized Epilepsy

From the Cardiovascular Study Group, Institute of Medicine; Division of Cardiology, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung City, Taiwan

Correspondence: Corresponding author: Kwo-Chang Ueng, MD, PhD, Cardiovascular Study Group, Institute of Medicine; Department of Medicine, Division of Cardiology, Chung Shan Medical University Hospital, 110, Sec.1, Jian-Guo N. Rd., Taichung City, 402, Taiwan (E-mail: cathroom.csh.org.tw;ueng.kc{at}msa.hinet.net)

Long QT syndrome is a potentially lethal cardiac channelopathy that can be mistaken for epilepsy in young people. We report a 17-year-old man who was initially treated as having both daytime and nocturnal idiopathic epilepsy for 5 years. A series of electrocardiograms showed the time of the convulsive episodes, and genetic testing lead to the final diagnosis. The combined use of a β-blocker and a pacemaker implant incompletely abolished the torsade de pointes. After an additional near-fatal event, a cardioverter defibrillator was implanted as final bridge therapy. An electrocardiogram with the correct calculation of the QT interval should be performed on all young people with a suggestive history; that is, treat refractory convulsive episodes specifically with nondiagnostic electroencephalograms.

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