Congenital Long QT Syndrome Masquerading as Epilepsy: A Case Report

In this case report, we present a 24-year-old woman with a previous diagnosis of epilepsy who was admitted to the hospital following loss of consciousness (LOC). It was initially assumed that this was an epileptic seizure based on her previous diagnosis of epilepsy; however, a review of her electrocardiograms (ECGs) revealed a prolonged QT interval. She was admitted to the cardiology ward for continuous ECG monitoring and subsequently developed self-limiting torsades de pointes (TDP). A diagnosis of congenital long QT syndrome (LQTS) was established, her anticonvulsant treatment was withdrawn, and she was managed with nadolol, mexiletine, and an implantable cardioverter defibrillator (ICD). This case underscores the importance of excluding cardiac disease with secondary anoxic seizures in patients with apparent epilepsy and in particular the need for all patients to have a baseline 12-lead ECG as part of their initial assessment.