Importance of cardiological evaluation for first seizures

Area of Science:

• Cardiology
• Neurology
• Genetics

Background:

• Long QT syndrome (LQTS) is a disorder of cardiac repolarization.
• LQTS can lead to life-threatening ventricular arrhythmias and sudden cardiac death.
• Seizures are not a commonly recognized initial presentation of LQTS.

Observation:

• Two cases are presented where LQTS initially manifested as seizures.
• Case 1 involved postpartum seizures followed by cardiac arrest due to LQTS.
• Case 2 presented with tonic-clonic seizures, prompting LQTS evaluation due to prior experience.

Findings:

• LQTS should be considered in the differential diagnosis of new-onset seizures.
• Prompt recognition and diagnosis of LQTS are critical for patient management.
• Diagnostic delay in LQTS can have severe consequences, including cardiac arrest.

Implications:

• This highlights the importance of considering cardiac etiologies in patients with seizures.
• Implementing LQTS screening in seizure workups may improve patient outcomes.
• Legal cases underscore the need for heightened awareness of LQTS in unexplained seizure presentations.