Lactate Compared to Creatine Kinase as Diagnostic Marker in Generalized Epileptic Seizure
Lactate Compared to Creatine Kinase as Diagnostic Marker in Generalized Epileptic Seizure
The investigators compared the feasibility of serum creatine kinase and serum lactate
 concentration as diagnostic markers to distinguish between generalized tonic-clonic seizures
 (GTCS) and syncopes in clinical settings that require fast-action treatment, such as in the
 emergency departments.
The patients of this prospective study were selected from a sample of patients who were
 admitted to the emergency room of the University Hospital RWTH Aachen with an unclear
 impairment of consciousness. Only patients who later on were diagnosed as having experienced
 a GTCS or a syncope and whose serum lactate concentrations had been measured within 2 hours
 after the event were enrolled in the study. The investigators compared the specificity and
 sensitivity of the serum lactate concentrations at admission with the CK concentration at
 admission and the CK follow-up taken 10 to 48 hours after the event.

 The values at admission were compared between patients from whom a blood sample was collected
 within 60 minutes after the event, and those from whom a blood sample was collected within
 61-120 minutes after the event.

 The comparison of initial lactate concentrations at admission with CK levels 10 - 48 hours
 later could only be performed on part of the patient collective because the other patients
 were already discharged at this time-point and could therefore not be included.

 The initial blood samples were taken at patient arrival in the emergency room. The follow up
 was performed during the inpatient stay.

 Serum lactate and CK concentrations between patient groups were statistically compared with a
 Mann-Whitney-U test. We defined cut-off values and their sensitivity and specificity by
 Receiver Operating Characteristic (ROC) analysis.
Inclusion Criteria:

 Patients with generalized tonic-clonic seizures and syncopes and whose blood samples were
 taken within 2 hours after the event

 18 years or older

 Observed seizure

 Time of the event before admission was known

 Diagnosis of an epileptic seizure or syncope had been entered in the final discharge report

 Exclusion Criteria:

 Prisoner

 Age < 18 years old

 Competing explanations for serum lactate or CK elevation e.g. shock or trauma

 Lack of capacity for consent