THE LONG Q-T SYNDROMES

Loss of consciousness in childhood may be due to cardiovascular causes , and the Long Q-T syndromes can present with seizures. The Romano-War d syndrome is of autosomal dominant inheritance, and the Jervell and L ange-Nielson syndrome, with associated deafness, of autosomal recessiv e inheritance. The diagnosis is often delayed, but a careful history c an avoid this. The syndromes can appear to be due to an imbalance in t he sympathetic nerve to the ventricular myocardium, and precipitating causes such as stress suggest a CNS influence on this. The electrocard iogram can confirm the prolonged Q-T interval, but this is not always present, at least without an exercise test. Treatment with beta-blocke rs is often successful. If a wrong diagnosis of epilepsy is made a cha nce may be missed of avoiding sudden death, quite apart from all the m edical, and social consequences that can result from such a diagnosis