Part 2:
"Long-QT Syndrome Easily Misdiagnosed As Epilepsy in Young People Unless ECG Performed, Physicians Caution
from Heartwire — a professional news service of WebMD
Shelley Wood
October 12, 2007 (Leuven, Belgium) - Physicians in Belgium are warning colleagues about a misdiagnosis they say may be relatively common, particularly among young patients, but easily prevented with electrophysiological studies. Writing in the October 2007 issue of Heart Rhythm, Dr Tom Rossenbacker (University of Leuven, Belgium) and colleagues describe the case of a 15-year-old girl, misdiagnosed with epilepsy at age 11 and treated fruitlessly with antiepileptic drugs for four years before her true condition--long-QT syndrome--was discovered [1]."
Full article:
http://www.medscape.com/viewarticle/564212?src=mp
This is a press release from the American College of Cardiology:
ACC News Releases
Contact:
media@acc.org
Seizure-Like Attacks May Mean Cardiovascular Problems, Not Epilepsy
(July 1, 2000)--Physicians have long suspected that many patients being treated for epilepsy aren't actually suffering from the disease. Now a new study published in the July 2000 issue of the Journal of the American College of Cardiology reveals that the rate of misdiagnosis may be more than 40 percent.
"Two out of five patients in our study had been told that their blackouts were caused by epilepsy, and many were taking powerful drugs to treat the condition--with little if any benefit," explained lead author Dr. Amir Zaidi, of the Manchester Heart Centre at the Royal Infirmary in Manchester, England. "In reality, these patients had heart or circulation problems that could be effectively treated with cardiac drugs or pacemakers."
The study was born when local neurologists began sending Dr. Zaidi epilepsy patients who had uncertain diagnoses or who had failed to respond to anticonvulsant medication. In the resulting study, Dr. Zaidi and his colleagues put 74 of these patients through simple cardiovascular tests--head-up tilt tests and carotid sinus massage--to see if their problems were really cardiovascular in nature. In the head-up tilt test, patients are strapped to a table and slowly tilted until they are nearly vertical; blood pooling in the legs reduces blood flow to the heart and causes fainting in susceptible individuals. In carotid sinus massage, pressing on the carotid artery in the neck slows the heart down and causes fainting in susceptible individuals.
What Dr. Zaidi and his research team found surprised them. Almost 42 percent of the patients had been incorrectly diagnosed with epilepsy. Instead, many suffered from a severe form of fainting called vasovagal syncope.
"We were taken aback by the level of misdiagnosis, which was at least twice as high as expected," said Dr. Zaidi, noting that other studies have suggested misdiagnosis rates of only 20 percent. "The most important message of our study is that if a patient with seizure-like attacks thought to be caused by epilepsy does not respond to treatment, the physician should reconsider the diagnosis."
For Dr. Melvin M. Scheinman, of the University of California, San Francisco, the study's value lies in its discovery of just how common the misdiagnosis of epilepsy is.
"It has long been appreciated that apparent 'epileptic fits' may have a cardiac cause," said Dr. Scheinman. "The importance of Dr. Zaidi's study is to highlight the frequency of this association."
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http://www.acc.org/media/releases/hi...00/seizure.htm
http://heartdisease.about.com/cs/generallinks/a/syncopeseizure.htm
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