The Value of Simultaneous Electrocardiography Recording in the EEG Laboratory

Background: The aim of the current study was to assess the value of simultaneous EKG with EEG to diagnose cardiac disorders in patients with seizure- like attacks and to investigate the extent of misdiagnosis of epilepsy. Materials and Methods: 210 patients presenting with transient loss of consciousness (TLoC) and paroxysmal events suspicious to seizure were studied. All patients had undergone EEG simultaneous with an EKG. Besides reporting the EEG, a cardiologist analyzed the EKG in an attempt to recognize abnormal EKG as a potential cause of TLoC. Moreover, in all patients it was ascertained if any cardiac disorders in patients and their first degree relatives had been diagnosed. Results: Sixteen out of two hundred ten (7.6%) patients had abnormal EKG which was significantly potential cause of symptom of whom 6 patients were found to have bradycardia and 10 patients had dysrhythmias. Moreover, in patients with previous cardiovascular disorder, 30.4% had abnormal EKG where as in patients without cardiac disease only 4.8% had EKG abnormalities. Besides in patients with positive family history for cardiac disease 20.3% had abnormal EKG while in patients without family history of cardiac disease, abnormal EKG was revealed in only 2.05% patients. Conclusion: Simultaneous EKG with EEG is valuable in declining rate of misdiagnosis of epilepsy. Besides, EKG abnormalities in these patients have a significant association with any previous cardiovascular disorders in the patients and in their first degree relatives.