[Ventricular fibrillation or general seizure?]

Area of Science:

• Cardiology
• Neurology
• Endocrinology

Background:

• Hypoglycemia can present with diverse neurological symptoms, including seizures.
• Cardiac arrhythmias can mimic or coexist with neurological events.

Observation:

• A 78-year-old male experienced recurrent seizures attributed to marginal hypoglycemia.
• The patient developed loss of consciousness and generalized seizures.
• Electrocardiogram (ECG) monitoring revealed repetitive ventricular fibrillation.

Findings:

• Ventricular fibrillation, initially suspected to be seizure-related, was identified as the cause of the patient's altered consciousness.
• Marked hypokalemia (1.8 mmol/L) was diagnosed as the underlying cause of the ventricular fibrillation.
• Treatment involving normalization of serum potassium levels successfully terminated the cardiac events.

Implications:

• This case highlights the critical importance of considering electrolyte imbalances, particularly hypokalemia, in patients presenting with altered consciousness and seizures.
• Continuous ECG monitoring is crucial for diagnosing life-threatening arrhythmias that may present with neurological symptoms.
• Early and accurate diagnosis of hypokalemia can prevent potentially fatal cardiac events and neurological complications.