Skull Base Research Center, Loghman Hakim Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Department of epilepsy, Loghman Hakim Hospital, Shaheed Beheshti University of Medical Sciences, South Kargar Ave., Kamali St., Tehran, Iran.
Seizure. 2018 Oct;61:41-44. doi: 10.1016/j.seizure.2018.07.010. Epub 2018 Jul 23.
There has been increasing interest in the use of different biomarkers to help distinguish psychogenic from epileptic seizures, in patients presenting acutely with seizure-like events. In the present study, we measured serum glial fibrillary astrocytic protein (GFAP) levels in patients presenting with such events who were subsequently diagnosed as epileptic seizures (ESs) or psychogenic non-epileptic seizures (PNESs) and compared GFAP levels obtained with those found in healthy subjects.
Sixty-three patients with seizures (43 with ES and 20 with PNES), and 19 healthy subjects participated in the study. Venous blood samples were obtained within the first 6 h after seizures and serum GFAP levels were measured by protein quantification (ELIZA kit) with an electrochemical luminescence immunoassay.
Serum GFAP levels were significantly higher in patients with ES compared to PNES or healthy controls. A cut-off point of 2.71 ng/ml was found optimally to differentiate ES from PNES (sensitivity 72%, specificity 59%).
Our study suggests that post-seizure serum GFAP levels could be used in future studies better to understand the underlying mechanism of seizures and may offer as an adjunctive diagnostic test in differentiating ES from PNES.
人们越来越关注使用不同的生物标志物来帮助区分癫痫发作的精神性和癫痫性，这些患者表现为突发性类似癫痫发作的事件。在本研究中，我们测量了随后被诊断为癫痫发作（ES）或非癫痫性精神性发作（PNES）的此类事件患者的血清神经胶质纤维酸性蛋白（GFAP）水平，并将其与健康受试者的 GFAP 水平进行了比较。
63 名癫痫发作患者（43 名 ES 和 20 名 PNES）和 19 名健康受试者参与了研究。在癫痫发作后 6 小时内采集静脉血样，并通过电化学发光免疫分析的蛋白质定量（ELISA 试剂盒）测量血清 GFAP 水平。
ES 患者的血清 GFAP 水平明显高于 PNES 或健康对照组。发现 2.71ng/ml 的截断值可最佳地区分 ES 与 PNES（敏感性 72%，特异性 59%）。
我们的研究表明，癫痫发作后血清 GFAP 水平可用于未来的研究，以更好地了解癫痫发作的潜在机制，并可能作为区分 ES 与 PNES 的辅助诊断测试。
