Key result
A 57-year-old man with a history of systolic heart failure and an AICD presented with seizure-like episodes that were diagnosed as convulsive syncope secondary to ventricular tachycardia and fibrillation.
Case Report (n=1)
No
Early diagnosis of convulsive syncope secondary to cardiac arrhythmia is critical to prevent sudden cardiac death in patients presenting with presumed epileptic seizures.
Highlights potential misdiagnosis of cardiac syncope as epilepsy; leaves open whether systematic evaluation improves outcomes in larger cohorts.
It is important but difficult to distinguish convulsive syncope from epileptic seizure in many patients. We report a case of a man who presented to emergency department after several witnessed seizure-like episodes. He had a previous medical history of systolic heart failure and automated implantable converter defibrillator (AICD) in situ. The differential diagnoses raised were epileptic seizures and convulsive syncope secondary to cardiac arrhythmia. Subsequent AICD interrogation revealed ventricular tachycardia and fibrillation (v-tach/fib). Since convulsive syncope and epileptic seizure share many similar clinical features, early diagnosis is critical for choosing the appropriate management and preventing sudden cardiac death in patients with presumed epileptic seizure.
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John et al. (2016) conducted a case report in Convulsive syncope secondary to ventricular arrhythmia (n=1). Amiodarone and electrolyte correction was evaluated. A 57-year-old man with a history of systolic heart failure and an AICD presented with seizure-like episodes that were diagnosed as convulsive syncope secondary to ventricular tachycardia and fibrillation.
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