Wang Kai, Yang Jinwei, Xu Wenhao, Wang Lei, Wang Yu
The First Affiliated Hospital of Anhui Medical University Hefei China.
Clin Case Rep. 2023 Aug 16;11(8):e7788. doi: 10.1002/ccr3.7788. eCollection 2023 Aug.
Motor signs accompanying seizures have been considered to result in overexertion of muscles and have the ability to cause elevated levels of serum creatine kinase (CK). There were no previous studies on the treatment of seizure-induced elevated CK. We summarized the characteristics and treatments of six patients with significant elevation of CK after seizure onset. There were four males and two females, the age range was 16-68 years. The CK levels were greater than 5000 U/L in five of the six patients and the highest CK level was 39,300 U/L. All patients exhibited an estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73m. No patient developed renal failure or required continuous renal replacement therapy. We determined that serial assessment of CK, myoglobin, eGFR, and electrolytes should be performed in patients following seizures. Furthermore, fluid resuscitation, urine alkalization, and diuretic agents should be administrated when CK are significantly elevated after seizure onset. Serial assessment of CK levels after seizures should be performed, especially when the patient experiences electrolyte disorders. Fluid resuscitation, urine alkalization, and diuretic agents also should be administrated to patients when they exhibit a significantly elevated CK or myoglobin after seizures.
癫痫发作时伴随的运动体征被认为会导致肌肉过度劳累，并有可能导致血清肌酸激酶（CK）水平升高。此前尚无关于治疗癫痫诱发的CK升高的研究。我们总结了6例癫痫发作后CK显著升高患者的特征及治疗情况。其中男性4例，女性2例，年龄范围为16 - 68岁。6例患者中有5例的CK水平大于5000 U/L，最高CK水平为39300 U/L。所有患者的估算肾小球滤过率（eGFR）均<90 mL/min/1.73m²。无一例患者发生肾衰竭或需要进行持续肾脏替代治疗。我们确定癫痫发作后的患者应进行CK、肌红蛋白、eGFR和电解质的系列评估。此外，癫痫发作后CK显著升高时，应进行液体复苏、尿液碱化并使用利尿剂。癫痫发作后应进行CK水平的系列评估，尤其是当患者出现电解质紊乱时。当癫痫发作后患者的CK或肌红蛋白显著升高时，也应对其进行液体复苏、尿液碱化并使用利尿剂。
