Department of Neurology, Bolu Abant Izzet Baysal University, Bolu, Turkey.
Department of Emergency Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey.
Medicine (Baltimore). 2021 Sep 24;100(38):e27329. doi: 10.1097/MD.0000000000027329.
It is important to diagnose epilepsy in a timely and accurate manner, and also to distinguish it from non-epileptic conditions. The present study was aimed at determining postictal serum prolactin levels and lactate dehydrogenase (LDH) activities in patients with new-onset seizure admitted to the emergency department in order to assess whether they could be used in the differentiation of epileptic seizure (ES) from nonepileptic seizure (NES).Eighty-five patients were included prospectively in this study. Patients were divided into 2 groups with respect to epilepsy diagnosis, and the final groups were comprised of 36 patients with ES and 49 patients with NES. Blood samples were obtained within 1 hour of seizure.No significant differences between groups were observed in prolactin levels and in the percentage of patients with abnormal prolactin level (P = .569 and .239, respectively). The median LDH activity was significantly higher in those with ES compared with those with NES (P = .031). The percentage of patients with elevated LDH levels was similar between 2 groups (P = .286).This was the first study to examine LDH activities in terms of its role in differentiation of seizure origin in the postictal period in patients hospitalized with seizure. Our study demonstrated that serum LDH activities within 1 hour after the seizure appear to be increased in patients with ES compared with those with NES, suggesting the potential role of LDH activities as a diagnostic tool in distinction of seizure types. Our study supports the hypothesis that LDH-antagonists may have a role in the management of seizure and epilepsy.
及时准确地诊断癫痫非常重要,同时也要将其与非癫痫性疾病区分开来。本研究旨在确定新发病例急诊就诊的癫痫发作患者发作后血清催乳素水平和乳酸脱氢酶(LDH)活性,以评估其是否可用于区分癫痫发作(ES)与非癫痫性发作(NES)。
本研究前瞻性纳入 85 例患者。根据癫痫诊断将患者分为 2 组,最终分为 36 例 ES 患者和 49 例 NES 患者。在发作后 1 小时内采集血样。
组间催乳素水平和催乳素水平异常患者的比例无显著差异(P=0.569 和.239)。ES 患者的 LDH 活性中位数明显高于 NES 患者(P=0.031)。2 组间 LDH 水平升高的患者比例相似(P=0.286)。
这是第一项研究,考察了发作后 1 小时内 LDH 活性在癫痫患者住院期间发作起源鉴别中的作用。我们的研究表明,与 NES 患者相比,ES 患者发作后 1 小时内血清 LDH 活性升高,提示 LDH 活性作为鉴别癫痫发作类型的诊断工具具有潜在作用。我们的研究支持 LDH 拮抗剂可能在癫痫发作和癫痫管理中发挥作用的假说。