Case of an Infant with Bradycardia and Hypotension due to Quinidine for Epilepsy

Quinidine is known as a prophylactic agent for supraventricular tachycardia. Recently, qunidine sometimes has been used as an antiepileptic drug. To date, However, there are few reports of its use in children or reports of side effects. The case is a 2-year-old boy with epilepsy with migrating focal seizures. Various antiepileptic drugs and corpus callostomy were ineffective, and quinidine was introduced. The dose was increased while frequently confirming blood concentration. Seizures decreased as the dose increased. One year after introducing quinidine, he was hospitalized for gastrostomy, bradycardia and hypotension and required rapid administration of saline and catecholamine temporarily. Blood concentration during hypotension was within the therapeutic range, but the electrocardiogram showed marked QT prolongation and bradycardia. It is necessary to manage quinidine as an antiepileptic drug by paying attention not only to blood concentration but also to changes in electrocardiogram and hemodynamics.