Puppala Sumirini, Pattnaik Srimant, Acharya Abhijit, Sahoo Srikanta, Choudhury Surjyaprakash S, Sirohi Tanuraj
Department of Neurology, IMS SUM Hospital, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India.
Department of Medicine, Swami Vivekananda Subharti University, Meerut, Uttar Pradesh, India.
Ann Neurosci. 2025 Mar 31:09727531251320158. doi: 10.1177/09727531251320158.
A kind of conversion condition known as psychogenic non-epileptic seizures (PNES) is characterised by brief episodes that resemble epileptic fits but lack electroencephalographic (EEG) confirmation. Although the clinical history plays a significant role in the seizure diagnosis, imaging and serum markers are included in the initial evaluation for patients who present to the emergency.
To validate the prevalence of serum ammonia as a biomarker in differentiating true epileptic and non-epileptic seizures.
The study was a hospital-based observational, prospective comparative study spanning over 2 years after surpassing the patient consent, inclusion and exclusion criteria.
The mean of the study participants were middle-aged, males predominant in IES and females in PNES. A slightly higher proportion of the patients in the IES group had episodes of less than 5 minutes in the PNES group, where episodes lasted between 5 to 10 minutes. Awareness of symptoms was observed more frequently in the PNES group. The area under the curve (AUC) for the serum ammonia level at arrival was 0.972 (95% CI: 0.94-0.99) with a value of < .001.
Mean serum ammonia levels at arrival and after 48 hours of admissions in the idiopathic epileptic seizure group were significantly higher compared to the PNES group with value < .001, validating its use as a biomarker.
一种称为精神性非癫痫性发作（PNES）的转换性疾病，其特征是发作短暂，类似癫痫发作，但缺乏脑电图（EEG）证实。虽然临床病史在癫痫发作诊断中起着重要作用，但对于急诊患者，初始评估还包括影像学和血清标志物检查。
验证血清氨作为鉴别真性癫痫发作和非癫痫发作生物标志物的患病率。
本研究是一项基于医院的观察性前瞻性比较研究，在超过患者同意、纳入和排除标准后进行了2年多。
研究参与者的平均年龄为中年，特发性癫痫发作（IES）组以男性为主，PNES组以女性为主。IES组发作时间少于5分钟的患者比例略高于PNES组，PNES组发作持续时间为5至10分钟。PNES组更常观察到对症状的知晓。入院时血清氨水平的曲线下面积（AUC）为0.972（95%CI：0.94-0.99），P值<0.001。
特发性癫痫发作组入院时和入院48小时后的平均血清氨水平显著高于PNES组，P值<0.001，证实其可作为生物标志物。
