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Case Reports
. 2020 Apr-Jun;21(2):114-117.
doi: 10.4103/HEARTVIEWS.HEARTVIEWS_34_20. Epub 2020 Jun 29.

Epilepsy and Brugada Syndrome: Association or Uncommon Presentation?

Mohamed Salah Abdelghani  1 , Ammar Chapra  1 , Nidal Asaad  1 , Sajad A Hayat  1
Affiliations
Case Reports

Epilepsy and Brugada Syndrome: Association or Uncommon Presentation?

Mohamed Salah Abdelghani et al. Heart Views. 2020 Apr-Jun.

Abstract

Brugada syndrome (BrS) is a rare genetic disease, of which its clinical manifestations include, but not limited to, syncope or sudden cardiac death. A 30-year-old Bangladeshi male patient with a past medical history of epilepsy was admitted following successful resuscitation from an out of hospital cardiac arrest secondary to ventricular fibrillation. Electrocardiogram (ECG) upon admission was suggestive of BrS type I. His old medical record showed similar ECG 2 months earlier when he had presented with syncope and was diagnosed with seizure. The correlation between BrS and epilepsy has been reported in the literature, discussing whether seizure is an uncommon presentation of BrS or whether epilepsy and BrS share similar genetic mutations that have the potential to cause both arrhythmia and seizures in some patients. Patients who present with seizure and ECG suggestive of Brugada pattern should be evaluated to rule out associated or underlying cardiac arrhythmia.

Keywords: Ablation; Brugada syndrome; channelopathy; epilepsy; right ventricular outflow tract; seizure; sudden death; ventricular arrhythmia.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Twelve lead electrocardiogram upon admission after the return of spontaneous circulation showing a pseudo right bundle branch block pattern with coved ST-segment elevation in the right precordial leads which is typical for Brugada type 1 pattern
Figure 2
Figure 2
Intracardiac electrogram showing one episode of ventricular fibrillation followed by appropriate implantable cardioverter-defibrillator shock
Figure 3
Figure 3
Electrocardiogram post right ventricular outflow tract ablation showing the resolution of Brugada pattern
Figure 4
Figure 4
Epicardial voltage map overlying the right ventricular outflow tract demonstrates a heterogeneous scar pattern. Red denotes the dense scar, healthy pink tissue, and the other colors represent varying the severity of scar in between. The low amplitude fractionated intracardiac electrograms depolarize late (beyond the end of QRS) in the scar regions and are targeted during ablation
See this image and copyright information in PMC

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