Matz O, Zdebik C, Zechbauer S, Bündgens L, Litmathe J, Willmes K, Schulz J B, Dafotakis M
Department of Neurology, University Hospital, Rheinisch-Westfälische Technische Hochschule [RWTH] Aachen University, Aachen, Germany.
Department of Neurology, University Hospital, Rheinisch-Westfälische Technische Hochschule [RWTH] Aachen University, Aachen, Germany.
Seizure. 2016 Aug;40:71-5. doi: 10.1016/j.seizure.2016.06.014. Epub 2016 Jun 23.
The diagnostic classification of disorders of consciousness is often challenging, particularly the distinction between epileptic and non-epileptic seizures. The aim of the study was to examine serum lactate as a diagnostic marker of transient loss of consciousness.
Serum lactate levels in blood samples drawn within 2h of the event were compared retrospectively between patients with generalized tonic-clonic seizures (n=195) and patients with other seizures (syncopes [n=52], psychogenic non-epileptic seizures [n=17], and complex focal seizures [n=37]), respectively.
Serum lactate in patients with generalized tonic-clonic seizures was significantly (p<0.001, Mann-Whitney-U test) increased in comparison to other forms of seizure incidences. The area under the ROC-curve was 0.94 (95% CI 0.91-0.96). For a cut-off concentration of 2.45mmol/l, the sensitivity was 0.88 and the specificity 0.87.
Serum lactate levels in the acute diagnosis were an excellent biomarker for the discrimination of generalized seizures from psychogenic non-epileptic and syncopal events, corroborating its importance for the standard work-up of acute disturbances of consciousness.
意识障碍的诊断分类通常具有挑战性，尤其是癫痫性发作与非癫痫性发作之间的区分。本研究的目的是检测血清乳酸作为短暂意识丧失的诊断标志物。
回顾性比较全身性强直阵挛发作患者（n = 195）与其他发作类型患者（晕厥[n = 52]、心因性非癫痫性发作[n = 17]和复杂局灶性发作[n = 37]）在事件发生后2小时内采集的血样中的血清乳酸水平。
与其他发作类型相比，全身性强直阵挛发作患者的血清乳酸水平显著升高（p < 0.001，Mann-Whitney-U检验）。ROC曲线下面积为0.94（95%CI 0.91 - 0.96）。对于2.45mmol/l的截断浓度，敏感性为0.88，特异性为0.87。
急性诊断中的血清乳酸水平是区分全身性发作与心因性非癫痫性发作和晕厥事件的优秀生物标志物，证实了其在急性意识障碍标准检查中的重要性。
