Clinical Practice and Cases in Emergency Medicine (Jan 2017)

Methadone-induced Torsades de Pointes Masquerading as Seizures

  • David C. Traficante,
  • Gordon Feibish,
  • John Kashani

DOI
https://doi.org/10.5811/cpcem.2016.11.32664
Journal volume & issue
Vol. 1, no. 1

Abstract

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The authors herein present the case of a 53-year-old female who was being treated as an outpatient for seizure disorder but was also receiving high-dose methadone therapy. She presented to the emergency department (ED) for what appeared to be a seizure and was found to have a prolonged QT interval, as well as runs of paroxysmal polymorphic ventricular tachycardia with seizure-like activity occurring during the arrhythmia. The markedly prolonged QT interval corrected after treatment with intravenous magnesium; subsequent electroencephalogram, neurology and cardiology consultations confirmed the cause of the recurrent seizure-like episodes to be secondary to the cardiotoxic effects of methadone.