Elevations of troponin in patients with epileptic seizures? What do they mean?

Cardiac troponin concentrations are important sensitive and specific markers for myocardial injury in clinical medicine. Troponin (TnT) elevations have been noted in some series in the setting of acute neurologic disease. We have previously reported that solitary seizures do not evoke elevations in TnT. The importance of this negative finding is exemplified by a patient who arrived at our clinic following a new onset seizure and in whom the cardiac TnT level was observed to rise. Triggered by this observation and by the knowledge that seizures alone would not do this, a subsequent targeted cardiologic workup documented what was believed to be an extension of a previously unrecognized myocardial infarction, with a seizure as its clinical presentation. Elevations of troponin should not be considered to be due to isolated seizures. This case illustrates the importance of having data concerning the response of troponin in various emergency and clinical situations.