Choong H, Hanna I, Beran R. Importance of cardiological evaluation for first seizures. World J Clin Cases 2015; 3(4): 381-384 [PMID: 25879012 DOI: 10.12998/wjcc.v3.i4.381]
Corresponding Author of This Article
Roy Beran, Professor, Strategic Health Evaluators, Suite 5, 6th Floor, 12 Thomas Street, Chastwood, NSW 2067, Australia. roy.beran@unsw.edu.au
Research Domain of This Article
Medicine, Legal
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 16, 2015; 3(4): 381-384 Published online Apr 16, 2015. doi: 10.12998/wjcc.v3.i4.381
Importance of cardiological evaluation for first seizures
Ho Choong, Ibrahim Hanna, Roy Beran
Ho Choong, Ibrahim Hanna, Roy Beran, Department of Neurology and Neurophysiology Liverpool Hospital, Liverpool BC, NSW 1871, Australia
Roy Beran, School of Medicine, Griffith University, Southport, Queensland 4222, Australia
Roy Beran, Strategic Health Evaluators, Chastwood, NSW 2067, Australia
Author contributions: Choong H and Hanna I collected patients’ clinical data; Choong H searched for relevant references from pubmed; Choong H and Beran R wrote the paper.
Ethics approval: The nature of the presentation is not such that ethics approval is required; it is not a clinical trial and is not ethically sensitive.
Informed consent: There is no need to involve informed consent as it is a de-identified report and not involving any patient in any research project or study; it reports clinical experience and all clinicians involved have consented to its release.
Conflict-of-interest: There is no conflict of interest for any of the authors.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Roy Beran, Professor, Strategic Health Evaluators, Suite 5, 6th Floor, 12 Thomas Street, Chastwood, NSW 2067, Australia. roy.beran@unsw.edu.au
Telephone: +61-2-94153800
Received: June 5, 2014 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
Abstract
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.
