Elderly patient with acquired long QT syndrome secondary to Levetiracetam

Martín, B. Rojano; Rubio, Manuel Pablo; Ornazabal, N. Bilbao; Martín‐Sánchez, Francisco Javier

doi:10.1016/s2173-5808(11)70026-8

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…Verrier et al even proposed the concept of "epileptic heart", suggesting that recurrent seizures could lead to repeated surges of plasma catecholamines and hypoxemia that lead to electrical and mechanical dysfunction of cardiac cells. By searching the Wanfang, CNKI and Pubmed databases using "antiepileptic drugs /AEDs/ASMs" and "LQTS" as keywords, a total of 21 articles were retrieved, including 12 case reports, 1 prospective study, 2 reviews, and 6 case-control studies, covering a total of 12 ASMs [16][17][18][19]. Of the ASMs, sodium thiopental, chloronazepam, lorazepam, and levetiracetam have been reported to lead to LQTS; in particular, the Na + -blocker ASMs have more frequent inductions of LQTS.…”

Section: Discussionmentioning

confidence: 99%

“…Among them, TdP and ventricular fibrillation are key pointers to immediate drug withdrawal, and they are also the main causes of death. diLQTS caused by ASMs should be alerted, and ASMs should be stopped immediately upon the co-occurrence of TdP and ventricular fibrillation [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. The risk of Tdp can be increased in the cases of prolonged QTc, t-U wave malformation and T wave electric alternation.…”

Section: Discussionmentioning

confidence: 99%

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Case report of antiseizure medicine-induced long QT syndrome and a literature review

Zha

et al. 2022

Acta Epileptologica

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Background To realize the clinical characteristics of long QT syndrome (LQTS) caused by antiseizure medicines (ASMs), and to improve the prevention and management of ASM-acquired QT syndrome. Case presentation A case of ASM-acquired QT syndrome was diagnosed and relevant literature was reviewed. The case was a 7-year-old boy who presented with a sudden onset of panic followed by changes in consciousness, with or without convulsions, lasting from tens of seconds to 3 min. The patient then received antiepileptic treatment with valproic acid, levetiracetam and oxcarbazepine and was seizure free for about a year. However, on August 12, 2021, his illness flared up again. Electroencephalogram (EEG) showed the background activity was slow, and no obvious epileptic discharge was detected. But electrocardiogram (ECG) showed a surprisingly prolonged QT interval (770 ms). Torsades de Pointes was found during Holter monitoring, while electrolyte levels were normal. The ECG recordings gradually returned to normal after stopping ASMs. For literature search, only 21 related papers were obtained after reading titles and full-texts of 105 English-language papers retrieved using keywords "acquired QT interstitial syndrome/acquired Long QT Syndrome (aLQTS)" and "anti-epileptic seizure drugs/ASMs", in the databases of Wanfang, CNKI, Pubmed, and other databases, from publication year 1965 to October 26, 2021. There are 12 types of drug-acquired LQTS caused by ASMs, most of which are Na+ blockers, but LQTS caused by oxcarbazepine had not been reported previously. Conclusions ASMs such as oxcarbazepine can cause acquired LQTS. When Na+ or K+ channel blockers are used clinically, ECG should be reviewed regularly and abnormal ECG should be intervened in time to reduce iatrogenic accidents in patients with epilepsy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Case report of antiseizure medicine-induced long QT syndrome and a literature review

Zha

et al. 2022

Acta Epileptologica

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“…In clinical studies in healthy adults, levetiracetam had no effect on QTc interval. However, there have been case reports of QTc interval prolongation with levetiracetam in a 24-year-old woman with a seizure disorder and previously undiagnosed long QT syndrome6 and an elderly patient with acquired long QT syndrome secondary to levetiracetam 7…”

Section: Effect Of Antiepileptic Drugs On Arrhythmiamentioning

confidence: 99%

Long QT syndrome masquerading as epilepsy

et al. 2018

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The diagnosis of epilepsy is incorrect in up to 20% of cases so should be revisited if attacks are not responding to treatment. We present a case of long QT syndrome that remained undiagnosed in the epilepsy clinic for 15 years until a near-fatal arrhythmia revealed the diagnosis and allowed effective treatment of her attacks. We hope this near miss raises awareness of long QT syndrome as a potentially fatal, rare but treatable condition that neurologists must consider in people with a label of refractory epilepsy. We provide practical pointers to increase the chance of early diagnosis and explore the impact of a late diagnosis for the patient and her family.

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Elderly patient with acquired long QT syndrome secondary to Levetiracetam

Cited by 2 publications

References 6 publications

Case report of antiseizure medicine-induced long QT syndrome and a literature review

Case report of antiseizure medicine-induced long QT syndrome and a literature review

Long QT syndrome masquerading as epilepsy

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