Clinical characteristics of Brugada-like electrocardiogram patter in 17 epileptic patients

Abstract

Objective To evaluate the clinical characteristics and prognosis of epileptic patients(EP)with Brugada-like electrocardiogram(Bru-ECG)patter. Methods Tow thousand and eighteen EP were enrolled from May 2002 to November 2013.A randomized, double-blind study was performed.17 EP with Bru-ECG patter(group 1)were randomly compared with those in control group(17 patients without Bru-ECG patter, group 2)after seizure disorder.Characteristics of baseline, ECG, electroencephalogram(EEG), serum potassium concentration(SPC), drugs were compared between two groups.All EP were long-term follow-up and sodium-channel blocker test(SCBT)was performed and SCN5A mutations were collected. Results There were 14(82.35%)and 3(17.65%)EP with type 1 and 2 Bru-ECG patter, respectively.EP with more prevalence of males and right temporal lobe epilepsy, elder, longer durations and more fluctuation of mean ventricular rates were more likely to be with Bru-ECG patter(P>0.05). There were no significant differences in course, type of epilepsy, disorder degree of EEG, QT interval, fluctuation of SPC, and related drugs token between two groups(P>0.05). Bru-ECG patter disappeared in 15(88.24%)EP in(11.71±9.62)hours.With a mean follow-up of(3.85±1.74)years, 3(17.65%)EP transiently reappeared Bru-ECG patter, 3(17.65%)patients remained with Bru-ECG patter even without drug intervention, 2 in 15 patients(6.67%)got a positive SCBT, 2(11.76%)EP had an SCN5A mutation remained with type I Bru-ECG patter.One male patient suffered from malignant arrhythmias featured with positive SCBT, sustained type I Bru-ECG and SCN5A mutation. Conclusion EP with Bru-ECG patter characterized by more common in male, right temporal lobe located and type I, elder, higher ventricular rate, and more durations of seizure disorder compared with those without Bru-ECG patter.Most of EP with Bru-ECG patter are transient, less experience of recurrent attacks, and have a relative satisfied prognosis and a low incidence, whereas to those considered as BrS, more attention should be paid for further treatment. Key words: Epilepsy; Brugada-like electrocardiogram; Brugada syndrome; Clinical characteristic