Correlation between seizure in children and prolonged QT interval

Area of Science:

• Cardiology
• Neurology
• Pediatrics

Background:

• Long QT syndrome is a cardiac electrical disorder associated with fatal ventricular arrhythmias.
• Seizures can be a symptom of Long QT syndrome, with up to 35% potentially misdiagnosed.
• Identifying the cardiac origin of seizures is crucial for appropriate patient management.

Purpose of the Study:

• To investigate the prevalence of Long QT syndrome in children presenting with seizures of unknown etiology.
• To compare the incidence of Long QT syndrome between children with seizures and a control group without seizures.
• To highlight the importance of electrocardiography in the diagnostic workup of unexplained seizures.

Main Methods:

• A case-control study was conducted with 508 pediatric participants.
• The case group comprised children with primary seizures of unknown origin; the control group included children hospitalized for other reasons.
• Corrected QT interval (QTc) was measured via electrocardiogram, with Long QT defined as QTc > 0.46 seconds.

Main Results:

• The study included 254 children in the case group and 254 in the control group.
• A statistically significant higher prevalence of Long QT was observed in children with seizures (66) compared to the control group (48) (P = 0.02).
• No significant differences in syncope or sudden death rates were found between the groups.

Conclusions:

• Children with unexplained seizures more frequently exhibit prolonged corrected QT intervals (QTc).
• This finding suggests a potential arrhythmic origin for some seizures in pediatric patients.
• Electrocardiography is recommended for all children presenting with seizures of unknown cause to screen for Long QT syndrome.