{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:40:06Z","timestamp":1756363206193,"version":"3.44.0"},"reference-count":5,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2016,3,8]]},"abstract":"<jats:p>A 30-year-old woman presented to the emergency room with recurrent seizures for 5\u2005days. She had been diagnosed with epilepsy 2\u2005years previously but stopped treatment due to the side effects of her medications. She was now experiencing episodes every 15\u201330\u2005min. While undergoing a brain MRI to investigate for structural central nervous system pathology, she experienced another episode, preceded by prodromal symptoms. Polymorphic ventricular tachycardia was noted during the event. Further investigation revealed a normal QT interval, normal electrolyte panel, normal coronaries and severe left ventricular systolic dysfunction. Cardiac MRI revealed non-ischaemic cardiomyopathy. The patient was managed with heart failure and antiarrhythmic medications and an implantable cardioverter defibrillator. She remained symptom free at 6-month follow-up. This case highlights the importance of differentiating between cardiogenic syncope and epilepsy and reiterates the importance of re-evaluating a diagnosis of epilepsy when presentation is atypical or symptoms are refractory.<\/jats:p>","DOI":"10.1136\/bcr-2015-214286","type":"journal-article","created":{"date-parts":[[2016,3,23]],"date-time":"2016-03-23T12:36:29Z","timestamp":1458736589000},"page":"bcr2015214286","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["\u2018Refractory epilepsy\u2019: what lies beneath?"],"prefix":"10.1136","volume":"2016","author":[{"given":"Syedah Saira","family":"Bokhari","sequence":"first","affiliation":[{"name":"Department of Medicine, Aga Khan University, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satwat","family":"Hashmi","sequence":"additional","affiliation":[{"name":"Department of Biological and Biomedical Sciences, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,3,23]]},"reference":[{"doi-asserted-by":"publisher","key":"2025082723181120000_2016.mar23_2.bcr2015214286.1","DOI":"10.1016\/S0735-1097(00)00700-2"},{"key":"2025082723181120000_2016.mar23_2.bcr2015214286.2","first-page":"60","article-title":"Vasovagal syncope treated as epilepsy for 16 years","volume":"36","author":"Asadi-Pooya","year":"2011","journal-title":"Iran J Med Sci"},{"doi-asserted-by":"publisher","key":"2025082723181120000_2016.mar23_2.bcr2015214286.3","DOI":"10.1136\/heart.89.3.353"},{"key":"2025082723181120000_2016.mar23_2.bcr2015214286.4","first-page":"10","article-title":"Coexistence of inherited cardiac arrhythmia in Epilepsy as neuro-cardiac channelopathy: from hypothesis to evidence","volume":"1","author":"Omichi","year":"2014","journal-title":"Mol Cell Epilepsy"},{"doi-asserted-by":"publisher","key":"2025082723181120000_2016.mar23_2.bcr2015214286.5","DOI":"10.1016\/j.cpcardiol.2013.07.004"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2015-214286","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:18:17Z","timestamp":1756361897000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2015-214286"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,3,23]]},"references-count":5,"alternative-id":["10.1136\/bcr-2015-214286"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2015-214286","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2016,3,23]]}}}