John Libbey Eurotext

When the first seizure can be the last: ventricular fibrillation following a new-onset seizure Volume 22, numéro 5, October 2020


1 Department of Cardiology, The Royal Melbourne Hospital, Melbourne Health, Melbourne, Victoria, Australia
2 Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
3 Departments of Neurology and Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
4 Department of Neurology, Alfred Health, Melbourne, Victoria, Australia
* Correspondence: Anver Sethwala 300 Grattan Street, Parkville, VIC 3052, Australia

Sudden unexpected death in epilepsy (SUDEP) is the leading cause of epilepsy-related mortality. Its mechanisms remain incompletely understood. Post-ictal arrhythmias rather than ictal arrhythmias appear to be associated with an increased risk of SUDEP. Only a handful of individuals with epilepsy who have survived ventricular arrhythmias post seizure (near-SUDEP) are reported in the literature. We report a case of ventricular fibrillation following a first-ever unprovoked seizure in a patient without epilepsy, in whom a sinus rhythm was restored following cardioversion. A defibrillator was subsequently implanted. Our case suggests that even first seizures might account for some of the many cases of unexplained ventricular fibrillation or sudden cardiac death.