운동에 의해 유발된 발작 1례: 간질로 오인된 QT 연장 증후군
A Case with Excercise Induced Seizures: Long QT Syndrome Misdiagnosed as Epilepsy
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
저자들은 운동에 의해 유발되는 발작이 지속되어 수년간 간질로 치료받았던 6년 5개월 남아에서, 특징적으로 심전도에서 QTc 간격이 연장되어 있고, 운동 유발 검사에서 다형성 심실 빈맥 소견을 보여 QT 연장 증후군으로 진단하고 베타 수용체 차단제로 치료하면서 추적 관찰 중인 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.
Abstract
Long QT syndrome(LQTS) is characterized by prolongation of the QT interval, frequent episodes of syncope, and ventricular tachycardia leading to sudden cardiac death in adolescents and young adults. Early diagnosis and prompt treatment to reduce the risk of life-threatening cardiac events is crucial, however sudden onset convulsive syncope may be misdiagnosed as epilepsy and lead to antiepileptic drug therapy for many years. We experienced a case of six-year-old boy who were having seizure triggered by exercise and being treated with antiepileptic drugs. He had normal EEG and brain MRI but his ECG revealed prolonged QT interval(QTc= 477 ms) and treadmill test induced polymorphic ventricular tachycardia. After applying β-blocker, he had no more seizure attacks. We report a case of long QT syndrome misdiagnosed as epilepsy with a brief review of related literatures.
참고문헌 (18)
- Michael Vincent G, "Long QT Syndrome", Cardiology Clinics, 18, pp.309~325 (2000)
- O'callaghan CA, "Prolonged QT syndrome presenting as epilepsy", Lancet, 341, pp.759~760 (1993)
- Pacia SV, "The prolonged QT syndrome presenting as epilepsy: a report of two cases and literature review", Neurology, 44, pp.1408~1410 (1994)
- Zaidi A, "Misdiagnosis of epilepsy: many seizure-like attacks have a cardiovascular cause", J Am Coll Cardiol, 36, pp.181~184 (2000)
- MacCormick JM, "Misdiagnosis of long QT syndrome as epilepsy at first presentation", Ann Emerg Med, 54, pp.26~32 (2009)
- Goldenberg I, "QT interval: how to measure it and what is" normal"", J Cardiovasc Electrophysiol, 17, pp.333~336 (2006)
- Ylanen K, "Catecholaminergic polymorphic ventricular tachycardia", Eur J Pediatr (2010)
- Jervell A, "Congenital deaf-mutism, functional heart disease with prolongation of the QT interval, and sudden death", Am Heart J, 54, pp.59~68 (1957)
- Romano C, "Aritmie cardiache rare dell'eta pediatrica", Clin Pediatr, 45, pp.656~683 (1963)
- Hedley PL, "The genetic basis of long QT and short QT syndromes: a mutation update", Hum Mutat, 30, pp.1486~1511 (2009)
- Schwartz PJ, "The congenital long QT syndromes from genotype to phenotype: clinical implications", J Int Med, 259, pp.39~47 (2006)
- Monteforte N, "The long QT syndrome and catecholaminergic polymorphic ventricular tachycardia", Pacing Clin Electrophysiol, 32, pp.S52~S57 (2009)
- Schwartz PJ, "Diagnostic criteria for the long QT syndrome. An update", Circulation, 88, pp.782~784 (1993)
- Tester DJ, "Effect of clinical phenotype on yield of long QT syndrome genetic testing", J Am Coll Cardiol, 47, pp.764~768 (2006)
- Goldenberg I, "Long QT syndrome", J Am Coll Cardiol, 51, pp.2291~2300 (2008)
- Goldenberg I, "Risk factors for aborted cardiac arrest and sudden cardiac death in children with the congenital long-QT syndrome", Circulation, 117, pp.2184~2191 (2008)
- Moss AJ, "Effectiveness and limitations of beta-blocker therapy in congenital long-QT syndrome", Circulation, 101, pp.616~623 (2000)
- Schwartz PJ, "The idiopathic long QT syndrome: pathogenetic mechanisms and therapy", Eur Heart J, 6, pp.103~114 (1985)