[Ventricular fibrillation or general seizure?].

A 78-year-old patient seemed to have recurrent seizures due to marginal hypoglycaemia. He was initially awake with stable circulation. Subsequently, he lost consciousness followed by extensie twitching arms of his arms and the upper part of his body. Thereafter, the patient was somnolent, but accessible. Initially hypoglycemia was thought to have caused general seizures. But the ECG monitor showed repetitive ventricular fibrillation, which was terminated by a cardioverter-defibrillator that had been implanted 3 years previously because of dilatative cardiomyopathy. At admission to hospital, marked hypokalemia (1,8 mmol/l) was noted as the cause of ventricular fibrillation. After normalization of serum potassium no further events occurred. Disorders of consciousness always request an ECG for early diagnosis.