[Romano-Ward syndrome initially diagnosed as epilepsy]

Area of Science:

• Cardiology
• Genetics
• Neurology

Background:

• Romano-Ward syndrome is a rare inherited disorder affecting heart rhythm.
• It is characterized by a prolonged QT interval, increasing the risk of dangerous arrhythmias.
• Genetic mutations in ion channel genes are the primary cause.

Observation:

• This report describes a unique case where Romano-Ward syndrome manifested primarily as epilepsy.
• The patient presented with seizure-like activity, initially obscuring the underlying cardiac condition.
• Diagnostic challenges arose due to the atypical presentation.

Findings:

• The case underscores the importance of considering Romano-Ward syndrome in epilepsy presentations, especially with a family history or suggestive ECG findings.
• Characteristic symptoms of Romano-Ward syndrome, including syncope and sudden cardiac death, may be absent or overshadowed by neurological symptoms.
• Thorough diagnostic evaluation is crucial to differentiate from primary epilepsy.

Implications:

• Accurate and timely diagnosis of Romano-Ward syndrome is vital to prevent potentially fatal cardiac events.
• This case broadens the understanding of Romano-Ward syndrome's diverse clinical manifestations.
• It emphasizes the need for interdisciplinary collaboration between neurology and cardiology for complex cases.