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題名 | One Brugada Syndrome Patient with Ventricular Fibrillation Misdiagnosed as Secondary Epilepsy=誤診為繼發性癲癇的Brugada綜合症併心室顫動 |
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作者 | 黃冰生; 程穎; 解強; 曾蘊澄; 林桂雄; 馮燕玲; 吳鈺燕; 謝偉堅; | 書刊名 | Acta Cardiologica Sinica |
卷期 | 23:4 2007.12[民96.12] |
頁次 | 頁263-267 |
分類號 | 415.318 |
關鍵詞 | Brugada綜合症; 癲癇; 埋藏式心臟轉複除顫器; 心室顫動; Brugada syndrome; Epilepsy; ICD; Ventricular fibrillation; |
語文 | 英文(English) |
中文摘要 | 該患者為47歲的男性,在入院前的1月裡共有3次神志不清和抽搐發作。3年前因車禍導致右顳骨骨折。1月前,患者因神志不清和抽搐發作入院,行心電圖未見異常,診斷為繼發性癲癇。第二次入院后心電圖顯示心房纖顫,部分右室胸前導聯J點和ST段抬高。當患者神志不清和抽搐再次發作時,心電監護提示心室顫動。該患者植入埋藏式心臟轉複除顫器后未再有神志不清和抽搐的發作。此病例提示診斷為癲癇的患者應排外Brugada綜合征的可能。 |
英文摘要 | The patient was a 47-year-old male who had 3 syncope and convulsion episodes over a 1-month period. The patient experienced right temporal bone fracture 3 years previous to this admission. At the first admission period, his interictal electroencephalogram (EEG) was normal, but he was misdiagnosed as secondary epilepsy because of the history of temporal bone fracture. In second admission, his electrocardiogram (ECG) revealed atrial fibrillation, partial right bundle branch block (RBBB), and J-point and ST-segment elevation in right precordial leads. The ST-segment was downward elevation on lead v1. But the ST-segment showed typical coved-pattern ECG of Brugada syndrome on lead v2. While the patient was in syncope, the ECG monitor revealed ventricular fibrillation. The ST-segment fell to the basic level on lead v1 and the coved-pattern ECG disappeared on lead v2 after administration of intravenous isoprenaline (0.25μg/kg•min) for 2 hours. The patient was free of syncope and convulsion after implanted implantable cardioverter defibrillator (ICD) and administration of amiodarone to preven1 atrial fibrillation At first admission, the patient was diagnosed secondary epilepsy because of the history of temporal hone fracture, syncope and convulsion, although there was the normal interictal electroencephalogram. It was regretted that we didn't follow him up further. |
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