Abstract Details

Title Biological markers for differentiating seizure

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P7 - Poster Session 7 (5:30 PM-6:30 PM)

Poster/Presentation
Number 12-001

Objective The need for a biological marker to diagnose seizure among the patients with a loss of consciousness has been emphasized from past studies. The elevation of creatine phosphokinase(CK), prolactin, neuron-specific enolase(NSE), ammonia has introduced as a tool, but each has its limitations in the clinical field.

Background The purpose of this study is to analyze the effectiveness of biological markers to diagnose seizure in the emergency department.

Design/Methods Adult patients who were admitted to the Department of Neurology at Gangnam Severance Hospital with final diagnosis of a generalized tonic–clonic seizure were eligible for this study and underwent analysis of serum biochemistry, including CK, prolactin, NSE and ammonia. These patients had blood test within 8hr after a brain insult in the emergency department. We compared the predictive factor of each biochemical examination.

Results We enrolled 36 patients who had final confirmed diagnosis of a generalized tonic–clonic seizure and underwent analysis of serum CK, prolactin, NSE and plasma ammonia (25 males, 11 females). NSE is the most predictive biological marker to diagnose seizure in our study (AUC: NSE 0.995 > ammonia 0.784 > CK 0.741 > prolactin 0.566). These biologic marker’s sensitivities and specificities by the cut-off points were NSE 86.1% and 100%, ammonia 69.4% and 76.9%, CK 80.6% and 51.3%, prolactin 38.9% and 59.0%, respectively.

Conclusions Serum NSE and plasma ammonia measurement during acute post-ictal period in emergency department may be useful tests for the identification and diagnosis of a seizure rather than serum CK and prolactin. Clinicians should consider the use of biological marker to differentiate seizure from many other disorders which can be altered mental status.

Authors/Disclosures
Yoojin Lee, MD (Asan Medical Center) PRESENTER	No disclosure on file
Won-Joo Kim, MD	No disclosure on file
	No disclosure on file
	No disclosure on file

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Abstract Details