Published online Apr 16, 2015. doi: 10.12998/wjcc.v3.i4.381
Peer-review started: June 8, 2014
First decision: June 27, 2014
Revised: January 20, 2015
Accepted: February 4, 2015
Article in press: February 9, 2015
Published online: April 16, 2015
Processing time: 312 Days and 2.3 Hours
This paper reports two cases of long QT syndrome (LQTS) which presented with seizures as their initial feature. Case 1, AB was seen in emergency department with post-partum seizure, discharged and re-presented following cardiac arrest associated with LQTS. Case 2, CD presented initially with tonic-clonic seizure and because of experience with AB, CD was assessed for LQTS which was subsequently confirmed. The legal medicine experience re Dobler v Halverson, which involved a young boy with LQTS, who suffered cardiac arrest without prior diagnosis of LQTS, has reinforced the requirement to seriously consider LQTS as an aetiological factor in first seizure presentations.
Core tip: Long QT syndrome (LQTS), with subsequent cerebral ischemia due to cardiac dysrhythmia, may cause seizures. It is imperative to consider LQTS in patients presenting with first seizure so as to avoid possible brain damage from prolonged cerebral hypoxemia. Failure to recognise LQTS may result in successful suit for negligence if not properly investigated and managed.