When a seizure is not a real seizure!

Talebi, Soheila; Ghobadi, Farzaneh; Chaudhari, Shobhana; Gracia, Ely; Ola, Olatunde; Pekler, Gerald; Visco, Ferdinand; Hassen, Getaw Worku

doi:10.1016/j.ajem.2015.07.077

Cited by 2 publications

(1 citation statement)

References 8 publications

(3 reference statements)

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“… 9 – 11 The reporting of seizure occurring during an episode of TdP has been reported in the medical literature. 12 – 15 Our patient was presumed to have a recently diagnosed seizure disorder and was started on antiepileptic medication; this differs from previously reported cases in which the patients were not being treated for seizure disorder as outpatients. The witnessing of what appeared to be a seizure occurring during an episode of TdP in our patient, as well as the negative work-up for seizures, solidifies the diagnosis of TdP-induced central nervous system hypoperfusion appearing to be a seizure.…”

Section: Discussioncontrasting

confidence: 62%

Methadone-induced Torsades de Pointes Masquerading as Seizures

Traficante¹,

Feibish²,

Kashani³

2017

CPCEM

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The authors herein present the case of a 53-year-old female who was being treated as an outpatient for seizure disorder but was also receiving high-dose methadone therapy. She presented to the emergency department (ED) for what appeared to be a seizure and was found to have a prolonged QT interval, as well as runs of paroxysmal polymorphic ventricular tachycardia with seizure-like activity occurring during the arrhythmia. The markedly prolonged QT interval corrected after treatment with intravenous magnesium; subsequent electroencephalogram, neurology and cardiology consultations confirmed the cause of the recurrent seizure-like episodes to be secondary to the cardiotoxic effects of methadone.

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