The prolonged Q-T syndrome presenting as a focal neurological lesion

A patient with a prolonged electrocardiographic Q-T interval suddenly developed left hemiplegia after an episode of ventricular fibrillation. A CT scan showed a cerebral infarction in the right internal capsule. The prolonged Q-T interval, by virtue of its association with cardiac arrhythmias, may cause cerebral hypoperfusion that commonly results in generalized neurological deficits. The lack of evidence for embolization in this patient suggests that decreased cerebral perfusion was responsible for the genesis of her neurological signs and symptoms. The prolonged Q-T interval is an easily overlooked cardiac abnormality that must be considered in a patient who exhibits a focal neurological deficit.