Key result
A first-ever unprovoked generalized tonic-clonic seizure triggered ventricular fibrillation in a healthy 24-year-old woman, suggesting that new-onset seizures can cause malignant arrhythmias.
Why the study?
Sudden unexpected death in epilepsy is the leading cause of epilepsy-related mortality, but its mechanisms remain incompletely understood and survivors of post-ictal ventricular arrhythmias are rarely reported.
Case Report (n=1)
This case highlights that even a first-ever unprovoked seizure can trigger malignant ventricular arrhythmias, suggesting a potential mechanism for some cases of unexplained sudden cardiac death.
Answers are grounded in this paper and cite their sources.
First unprovoked seizures may precipitate VF and SCD; single case leaves open S-ICD or epilepsy strategies to mitigate risk.
Sudden unexpected death in epilepsy (SUDEP) is the leading cause of epilepsy-related mortality. Its mechanisms remain incompletely understood. Post-ictal arrhythmias rather than ictal arrhythmias appear to be associated with an increased risk of SUDEP. Only a handful of individuals with epilepsy who have survived ventricular arrhythmias post seizure (near-SUDEP) are reported in the literature. We report a case of ventricular fibrillation following a first-ever unprovoked seizure in a patient without epilepsy, in whom a sinus rhythm was restored following cardioversion. A defibrillator was subsequently implanted. Our case suggests that even first seizures might account for some of the many cases of unexplained ventricular fibrillation or sudden cardiac death.
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Sethwala et al. (2020) conducted a case report in Ventricular fibrillation following new-onset seizure (n=1). First-ever unprovoked seizure was evaluated on Ventricular fibrillation. A first-ever unprovoked generalized tonic-clonic seizure triggered ventricular fibrillation in a healthy 24-year-old woman, suggesting that new-onset seizures can cause malignant arrhythmias.
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