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Clinical Profile of Pediatric Patients with Long QT Syndrome Masquerading as Seizures

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Abstract

Objective

To study the clinical profile of patients with long QT syndrome presenting as seizures.

Methods

Retrospective analysis of six pediatric patients admitted at authors’ institute between October 2008 and January 2013 with seizures and a presumptive diagnosis of long QT syndrome (LQTS) was done. The diagnosis was made on the basis of updated Schwartz diagnostic criteria. Clinical data, investigation profile and follow up of patients was recorded in a standard format and analysed.

Results

All the 6 patients in the study were boys with a mean age of 10.3 ± 2.8 y at the time of diagnosis. The lag period between symptom onset and diagnosis was 5.6 ± 3.14 y. All patients had history of seizures with a history of precipitating event in 4 patients. Average baseline QTc interval was 556 ± 41.31 ms. Mean Schwartz score was 6.66 ± 1.16. Polymorphic VT was documented in 4 patients. After initiating standard treatment with betablockers, nicorandil, spironolactone or pacemaker, all the six patients were asymptomatic at a mean follow up period of 17.5 mo, with no recurrence of seizures.

Conclusions

LQTS can cause seizures due to prolonged ventricular arrhythmias in high risk subgroup. Children, who present with LQTS and seizures, generally have a precipitating event causing seizures, and they respond well to drug therapy.

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Contributions

BT, TS and SS: Drafted the manuscript; AS: Reviewed and verified the pre and post procedure clinical data; SB: Analysis and interpretation of data and critical review of manuscript; JS: Collection of data and its analysis; TM: Revised the manuscript critically for important intellectual content. BT will act as guarantor for this paper.

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Authors and Affiliations

  1. Department of Pediatric Cardiology, U N Mehta Institute of Cardiology and Research Centre, Civil Hospital Campus, Asarwa, Ahmedabad, 380016, Gujarat, India

    Bhavesh Thakkar, Anand Shukla, Tarandeep Singh, Saurin Shah, Shomu Bohora, Jayal Shah & Tarun Madan

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  1. Bhavesh Thakkar
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  2. Anand Shukla
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  3. Tarandeep Singh
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  4. Saurin Shah
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  5. Shomu Bohora
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  6. Jayal Shah
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  7. Tarun Madan
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Corresponding author

Correspondence to Shomu Bohora.

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Thakkar, B., Shukla, A., Singh, T. et al. Clinical Profile of Pediatric Patients with Long QT Syndrome Masquerading as Seizures. Indian J Pediatr 81, 529–535 (2014). https://doi.org/10.1007/s12098-013-1305-3

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  • DOI: https://doi.org/10.1007/s12098-013-1305-3

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