When are episodes of loss of consciousness life-threatening?
Brna P, Camfield P, Camfield C, Messenger M, and Finley J (2006) When are episodes of loss of consciousness life-threatening? Paediatr Child Health 11:6 359–61.
Abstract: Episodic loss of consciousness is common in the paediatric population. While the majority of cases are due to benign conditions, life-threatening causes must be promptly identified.The present paper presents a case of recurrent loss of consciousness associated with convulsive activity and subsequent cardiac arrest due to a rare inherited ion channel disease known as Brugada syndrome. The case highlights the challenges of distinguishing epilepsy from convulsive syncope and the potentially disastrous consequences of an undiagnosed cardiac etiology. The most important paediatric causes of paroxysmal loss of consciousness and their salient features are reviewed. Clinical features suggesting a cardiac cause are emphasized because early recognition of these cases is critical.
Keywords: Brugada syndrome, Cardiac arrhythmia ,Seizures, Syncope
Context
- Report of single patient with repeated loss of consciousness with convulsions ultimately found to be due to Brugada syndrome, a rare inherited abnormality in myocardial activation linked to any of several genetic mutations. Serves as a reminder that convulsive loss of consciousness can have a cardiac cause . The possibility of a direct effect of the underlying ion channel mutation on brain electrical activity was not addressed, though the patient responded to pacemaker treatment (see Rocamora et al. for discussion of convulsive syncope). The authors discuss the possibility that arrhythmias such