O Matz1, C Zdebik2, S Zechbauer2, L Bündgens3, J Litmathe2, K Willmes2, J B Schulz4, M Dafotakis2. 1. Department of Neurology, University Hospital, Rheinisch-Westfälische Technische Hochschule [RWTH] Aachen University, Aachen, Germany. Electronic address: omatz@ukaachen.de. 2. Department of Neurology, University Hospital, Rheinisch-Westfälische Technische Hochschule [RWTH] Aachen University, Aachen, Germany. 3. Department of Medicine III, University Hospital, Rheinisch-Westfälische Technische Hochschule [RWTH] Aachen University, Aachen, Germany. 4. Department of Neurology, University Hospital, Rheinisch-Westfälische Technische Hochschule [RWTH] Aachen University, Aachen, Germany; JARA BRAIN Institute II, Jülich Aachen Research Alliance (JARA), FZ Jülich and RWTH Aachen University, Germany.
Abstract
PURPOSE: The diagnostic classification of disorders of consciousness is often challenging, particularly the distinction between epileptic and non-epileptic seizures. The aim of the study was to examine serum lactate as a diagnostic marker of transient loss of consciousness. METHOD: Serum lactate levels in blood samples drawn within 2h of the event were compared retrospectively between patients with generalized tonic-clonic seizures (n=195) and patients with other seizures (syncopes [n=52], psychogenic non-epileptic seizures [n=17], and complex focal seizures [n=37]), respectively. RESULTS: Serum lactate in patients with generalized tonic-clonic seizures was significantly (p<0.001, Mann-Whitney-U test) increased in comparison to other forms of seizure incidences. The area under the ROC-curve was 0.94 (95% CI 0.91-0.96). For a cut-off concentration of 2.45mmol/l, the sensitivity was 0.88 and the specificity 0.87. CONCLUSIONS: Serum lactate levels in the acute diagnosis were an excellent biomarker for the discrimination of generalized seizures from psychogenic non-epileptic and syncopal events, corroborating its importance for the standard work-up of acute disturbances of consciousness.
PURPOSE: The diagnostic classification of disorders of consciousness is often challenging, particularly the distinction between epileptic and non-epilepticseizures. The aim of the study was to examine serum lactate as a diagnostic marker of transient loss of consciousness. METHOD: Serum lactate levels in blood samples drawn within 2h of the event were compared retrospectively between patients with generalized tonic-clonic seizures (n=195) and patients with other seizures (syncopes [n=52], psychogenic non-epilepticseizures [n=17], and complex focal seizures [n=37]), respectively. RESULTS: Serum lactate in patients with generalized tonic-clonic seizures was significantly (p<0.001, Mann-Whitney-U test) increased in comparison to other forms of seizure incidences. The area under the ROC-curve was 0.94 (95% CI 0.91-0.96). For a cut-off concentration of 2.45mmol/l, the sensitivity was 0.88 and the specificity 0.87. CONCLUSIONS: Serum lactate levels in the acute diagnosis were an excellent biomarker for the discrimination of generalized seizures from psychogenic non-epileptic and syncopal events, corroborating its importance for the standard work-up of acute disturbances of consciousness.
Authors: M Dafotakis; J Heckelmann; S Zechbauer; J Litmathe; J Brokmann; K Willmes; R Surges; O Matz Journal: Nervenarzt Date: 2018-08 Impact factor: 1.214
Authors: Oliver Matz; Jan Heckelmann; Sebastian Zechbauer; Jens Litmathe; Jörg C Brokmann; Klaus Willmes; Jörg B Schulz; Manuel Dafotakis Journal: Intern Emerg Med Date: 2017-09-12 Impact factor: 3.397
Authors: Benjamin Kappler; Carlos A Ledezma; Sjoerd van Tuijl; Veronique Meijborg; Bastiaan J Boukens; Bülent Ergin; P J Tan; Marco Stijnen; Can Ince; Vanessa Díaz-Zuccarini; Bas A J M de Mol Journal: BMC Cardiovasc Disord Date: 2019-11-11 Impact factor: 2.298