Twelve-Year Follow-Up of a Teenager with Congenital Long QT Syndrome Presenting as Idiopathic Epilepsy

Congenital long QT syndrome (LQTS) is frequently misdiagnosed and maltreated due to its similar presentations to many disorders, most notably idiopathic epilepsy. The syndrome is characterized by a prolonged QT interval and T-wave morphology abnormalities in association with torsade de pointes. The heart is structurally and functionally normal. We report a 17-year-old male teenager who was initially treated as idiopathic epilepsy for 5 years. Clinical presentations, series examinations and inadequate response to anti-convulsant treatment lead to the final diagnosis of congenital long QT syndrome. Beta-blocker treatment was the treatment of choice, but it was complicated by severe bradycardia. A demand-type atrial chamber pacemaker (AAIR) was placed initially, but it was not sufficient. Dual-chamber implantable cardioverter-defibrillator (ICD) was the best solution for this patient.