Asher Lou Isenberg1, Mikkel Engberg Jensen2, Mette Lindelof2. 1. Neurological Department, University Hospital of Zealand - Roskilde, Denmark. Electronic address: asher.lou.isenberg@regionh.dk. 2. Neurological Department, University Hospital of Zealand - Roskilde, Denmark.
Abstract
PURPOSE: Differentiating between epileptic seizures, convulsive syncope or non-epileptic seizures is a common diagnostic challenge in the acute setting. Plasma-lactate levels have previously been proposed as a tool to aid in differentiating between epileptic and non-epileptic seizures, with lower levels of lactate suggesting a non-epileptic origin. The aim of this study was to investigate levels of lactate in non-epileptic seizures. METHODS: Healthy subjects were asked to perform a simulated seizure lasting no more than 5 min. Venous blood samples were taken before and immediately after the simulated seizure and analyzed using an ABL90 FLEX yielding information about lactate, pH, pO2,pCO2, electrolytes and plasma glucose. RESULTS: 8 people participated in the study: 6 men and 2 women aged 27-45. The average pre-simulation lactate was 1.1 mmol/L while the average pH was 7.39. The average post-simulation lactate was 10.2 mmol/L while the average pH was 7.25. This means an average increase in plasma-lactate of 9.1 mmol/L and an average drop of 0.15 in pH. CONCLUSION: Our data indicate that high rises in lactate levels are not specific for an epileptic origin. Further study of lactate as a marker for epileptic seizures is warrented.
PURPOSE: Differentiating between epileptic seizures, convulsive syncope or non-epileptic seizures is a common diagnostic challenge in the acute setting. Plasma-lactate levels have previously been proposed as a tool to aid in differentiating between epileptic and non-epileptic seizures, with lower levels of lactate suggesting a non-epileptic origin. The aim of this study was to investigate levels of lactate in non-epileptic seizures. METHODS: Healthy subjects were asked to perform a simulated seizure lasting no more than 5 min. Venous blood samples were taken before and immediately after the simulated seizure and analyzed using an ABL90 FLEX yielding information about lactate, pH, pO2,pCO2, electrolytes and plasma glucose. RESULTS: 8 people participated in the study: 6 men and 2 women aged 27-45. The average pre-simulation lactate was 1.1 mmol/L while the average pH was 7.39. The average post-simulation lactate was 10.2 mmol/L while the average pH was 7.25. This means an average increase in plasma-lactate of 9.1 mmol/L and an average drop of 0.15 in pH. CONCLUSION: Our data indicate that high rises in lactate levels are not specific for an epileptic origin. Further study of lactate as a marker for epileptic seizures is warrented.
Authors: Carl Magnusson; Johan Herlitz; Robert Höglind; Pär Wennberg; Anna Edelvik Tranberg; Christer Axelsson; Johan Zelano Journal: Epilepsia Date: 2021-01-08 Impact factor: 5.864