Key result
A patient misdiagnosed with refractory epilepsy for 15 years was found to have long QT syndrome after a near-fatal arrhythmia, highlighting the need to consider this treatable condition.
Case Report (n=1)
Highlights the importance of considering long QT syndrome in patients diagnosed with refractory epilepsy.
Answers are grounded in this paper and cite their sources.
Alerts neurologists to long QT as epilepsy mimic in nonresponders; leaves open the role of routine ECG screening in epilepsy clinics.
The diagnosis of epilepsy is incorrect in up to 20% of cases so should be revisited if attacks are not responding to treatment. We present a case of long QT syndrome that remained undiagnosed in the epilepsy clinic for 15 years until a near-fatal arrhythmia revealed the diagnosis and allowed effective treatment of her attacks. We hope this near miss raises awareness of long QT syndrome as a potentially fatal, rare but treatable condition that neurologists must consider in people with a label of refractory epilepsy. We provide practical pointers to increase the chance of early diagnosis and explore the impact of a late diagnosis for the patient and her family.
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Galtrey et al. (2018) conducted a case report in Long QT syndrome misdiagnosed as epilepsy (n=1). Diagnosis and treatment of long QT syndrome was evaluated. A patient misdiagnosed with refractory epilepsy for 15 years was found to have long QT syndrome after a near-fatal arrhythmia, highlighting the need to consider this treatable condition.
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