The role of creatine kinase in distinguishing generalized tonic–clonic seizures from psychogenic non-epileptic seizures (PNES) and syncope: a retrospective study and meta-analysis of 1300 patients

Neurological Research and Practice

Review

Ahmed Gaballa¹  Ramy Abdelnaby²  Jan Heckelmann²  Merna Wagih Youssef³  Khaled Ashraf Mohamed⁴  Anas Elgenidy⁴  Mohamed Ayman Ebrahim⁴  Mahmoud Mostafa Bedewy⁴  Khaled Abdelmoneim Elmenawi⁴  Abdelrahman M. Attia⁴  Ahmed Samy Shabib⁵  Mostafa Hossam Moawad⁶  Imene Maallem⁷ 

[1] Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Campus Bielefeld- Bethel, Bielefeld, Germany;Department of Neurology, RWTH Aachen University, Aachen, Germany;Faculty of Medicine, Alexandria University, Alexandria, Egypt;Faculty of Medicine, Cairo University, Cairo, Egypt;Faculty of Medicine, Mansoura University, Mansoura, Egypt;Faculty of Pharmacy, Clinical Department, Alexandria University, Alexandria, Egypt;Faculty of Medicine, Suez Canal University, Ismailia, Egypt;Faculté de Pharmacie, 23 Avenue Maquis du Grésivaudan, 38700, La Tronche, Grenoble, France;

关键词: Epileptic seizures;    Psychogenic non-epileptic seizures;    Syncope;    Generalized tonic-colonic seizure;    Creatine kinase;   

DOI  :  10.1186/s42466-023-00286-0

 received in 2023-07-11, accepted in 2023-09-26,  发布年份 2023

来源: Springer

【 摘 要 】

Background/aimAs the clinical differentiation between epileptic seizures, psychogenic non-epileptic seizures (PNES), and syncope depends mainly on a detailed report of the event, which may not be available, an objective assessment of a potential biochemical analysis is needed. We aimed to investigate whether serum creatine kinase (CK) could be used to differentiate epileptic seizure from PNES and syncope and to assess the strength of evidence present.MethodsWe directed a retrospective cohort study coupled with a systematic review and meta-analysis of studies that measured CK in patients with epilepsy, PNES, syncope, and healthy controls.ResultsThe cohort study, which traced 202 patients, showed that the CK level was significantly higher 48 h after the event in the epilepsy group versus patients with syncope (p < 0.01) Along with 1086 patients obtained through a database search for meta-analysis, CK level compared to different types of seizures from PNES was higher in epileptic seizure patients with a mean difference of 568.966 mIU/ml (95% CI 166.864, 971.067). The subgroup analysis of CK showed that it was higher in GTCS compared to syncope with a mean difference of 125.39 mIU/ml (95% CI 45.25, 205.52).DiscussionIncreased serum levels of CK have been associated mainly with epileptic seizures in relation to non-epileptic events. However, further studies would try to explore the variation in measurements and any other potential diagnostic marker.ConclusionThe cohort study shows that the CK level in epilepsy seizures is higher after 48 h from the event compared to syncope. Moreover, the meta-analysis results show the present diagnostic utility of CK and its importance to be used in accordance with a detailed report of the event.

【 授权许可】

CC BY   
© Deutsche Gesellschaft für Neurologie e.V. 2023

【 图 表 】

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