Masoumi Babak, Mozafari Safoura, Golshani Keihan, Heydari Farhad, Nasr-Esfahani Mohammad
Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Int J Prev Med. 2022 Apr 8;13:58. doi: 10.4103/ijpvm.IJPVM_129_20. eCollection 2022.
Seizure and syncope have similar clinical symptoms but different etiologies. Hence, differential diagnosis is crucial prior to intervention. This study evaluates the diagnostic importance of neuron specific enolase (NSE), creatine phosphokinase (CPK), and serum lactate dehydrogenase (LDH) for admitting patients with seizure medical history to emergency department (ED) in order for differential diagnosis between syncope and seizure.
Patients with a short-lasting loss of consciousness admitted to the ED were recruited. All patients with a short-lasting loss of consciousness were eligible and EEG was conducted several times and was taken over a long period. Patients were then divided into two groups of seizure and syncope. The biochemical markers levels of all the eligible patients were measured by a reputable laboratory.
In order to define specificity and sensitivity of different levels of biomarkers and the optimal cut-off points, ROC curves for each biomarker of syncope and seizure patients admitted to ED were performed. AUC for NSE, CPK, and LDH were 0.973 ± 0.023, 0.827 ± 0.047, and 0.836 ± 0.043 respectively in 95% confidence level. Cut-off points for NSE, CPK, and LDH were determined 25.12, 218.09, and 193.88 respectively.
It was concluded that NSE, CPK and LDH levels were different significantly in seizure patients compared to syncope ones. The seizure group showed an increase in NSE, CPK and LDH level.
癫痫发作和晕厥有相似的临床症状，但病因不同。因此，在进行干预之前进行鉴别诊断至关重要。本研究评估神经元特异性烯醇化酶（NSE）、肌酸磷酸激酶（CPK）和血清乳酸脱氢酶（LDH）对有癫痫病史的患者入住急诊科进行晕厥和癫痫鉴别诊断的诊断价值。
招募入住急诊科的短暂意识丧失患者。所有短暂意识丧失的患者均符合条件，多次进行脑电图检查且检查时间跨度较长。然后将患者分为癫痫组和晕厥组。所有符合条件的患者的生化标志物水平由一家知名实验室进行检测。
为了确定不同水平生物标志物的特异性和敏感性以及最佳截断点，对入住急诊科的晕厥和癫痫患者的每种生物标志物进行了ROC曲线分析。在95%置信水平下，NSE、CPK和LDH的AUC分别为0.973±0.023、0.827±0.047和0.836±0.043。NSE、CPK和LDH的截断点分别确定为25.12、218.09和193.88。
得出的结论是，癫痫患者的NSE、CPK和LDH水平与晕厥患者相比有显著差异。癫痫组的NSE、CPK和LDH水平升高。
