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Neurology (Expert Forum)
Connection between TLE and EKG abnormalities
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Connection between TLE and EKG abnormalities
by natsmomshell, Dec 09, 2003 12:00AM
I am a 37 yo female. I am seeing both a cardiologist and a neurologist right now. I was recently diagnosed with temporal lobe epilepsy (confirmed with EEG). I suffer daily partial and complex partial seizures for which I have just begun Trileptal (after suffering SJS on Lamictal). I also see the cardiologist for angina and palpitations and take Toprol daily and nitro as needed. One of the worst EKGs to date showed Prolonged QT (463), ST & T wave abnormalities, and low voltage QRS, which was at the ER on a day when I was most likely suffering a severe complex partial seizure. Heart cath and nuclear studies were normal however repeat stress tests have all been wildly abnormal. Are there any studies showing a correlation between epilepsy and disorders such as coronary artery spasms or long QT syndrome? Could one disorder be causing the other? The cardiologist wants to wait until I am on a theurapeutic dose of anti-seizure meds and then rerun the cardio tests but the neurologist thinks there is no connection. Would genetic testing be at all useful at this juncture? I am particularly worried since my 5 year old daughter is also suffering palpitations and seizures now, but since her QT interval is not prolonged, they are approaching it from the epilepsy standpoint rather than a cardiology one. Any guidance is appreciated.
Doctor's Answer
by CCF-Neuro-M.D.-CS, Dec 14, 2003 12:00AM
I can not find a connection between Trileptal and prolonged QT. Some patients with seizures can have abnormal caridac conduction during seizures, and in a small number of patients a seizure can result in the heart temporarily stopping. However in between seizures the epilepsy should not affect your cardiac rhythm. Therefore, I would recommend having the cardiac condition evaluated and only after the testing has been normal consider seizures as a cause. If seizures are causing the problem this can be documented by performing epilepsy monitoring. This involves being admitted to the hopsital (in a special epilepsy monitoring unit) and monitoring your heart rhythm when you have a seizure. Genetic testing for epilepsy is still only being used as a research tool. Good luck.
