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[Epilepsy/cardiac arrhythmia? Differential diagnostic problems]
I E Steffensen1, H V Nielsen, L C Laursen
1Medicinsk afdeling B, Centralsygehuset Hillerød.
Insights
Cardiac arrhythmias can mimic epilepsy symptoms. Two cases highlight Wolff-Parkinson-White syndrome and atrioventricular block presenting as suspected epilepsy, emphasizing the need for ECG and Holter monitoring.
Area of Science:
- Cardiology
- Neurology
Background:
- Epilepsy diagnosis can be challenging.
- Cardiac arrhythmias are sometimes misdiagnosed as seizures.
Observation:
- Two patients presented with suspected epilepsy.
- One patient had grand mal epilepsy and Wolff-Parkinson-White syndrome.
- Another patient, initially suspected of epilepsy, was diagnosed with third-degree atrioventricular block.
Findings:
- Cardiac arrhythmias, specifically Wolff-Parkinson-White syndrome and third-degree atrioventricular block, can present with seizure-like symptoms.
- Diagnostic evaluation for suspected epilepsy should include cardiac assessment.
Implications:
- Considering cardiac arrhythmias in epilepsy evaluations can prevent misdiagnosis.
- Electrocardiogram (ECG) and Holter monitoring are crucial diagnostic tools for differentiating cardiac from epileptic events.
Abstract:
In cases of suspected epilepsy the possibility of cardiac arrhythmias should be considered. Two case histories are presented. One patient had grand mal epilepsy combined with Wolff-Parkinson-White syndrome. In the other patient, epilepsy was suspected. However, the final diagnosis proved out to be third degree atrioventricular block. Examination must include an electrocardiogram and in case of doubt, Holter monitoring.