Epilepsy laboratory findings: Difference between revisions

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{{Epilepsy}}
{{Epilepsy}}
{{CMG}} {{AE}} {{VVS}}
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==Diagnosis==
The diagnosis of epilepsy requires the presence of recurrent, unprovoked seizures; accordingly, it is usually made based on the [[medical history]].  [[Electroencephalography|EEG]], brain [[MRI]], [[SPECT]], [[Positron emission tomography|PET]], and [[magnetoencephalography]] may be useful to discover an [[etiology]] for the epilepsy, discover the affected brain region, or classify the epileptic syndrome, but these studies are not useful in making the initial diagnosis.


[[Long-term video-EEG monitoring]] for epilepsy is the gold standard for diagnosis, but it is not routinely employed owing to its high cost, low availability and inconvenience.
== Overview ==
Laboratory findings consistent with the diagnosis of epilepsy include: Elevated [[creatine phosphokinase]] (CPK), elevated [[cortisol]], elevated [[white blood cell count]], elevated [[lactate dehydrogenase]] and elevated [[neuron-specific enolase]].


Convulsive or other seizure-like activity, non-epileptic in origin, can be observed in many other medical conditions. These [[non-epileptic seizures]] can be hard to differentiate and may lead to misdiagnosis.
==Laboratory Findings==
 
* Laboratory findings consistent with the diagnosis of a [[seizure]] attack include:<ref name="pmid15080857">{{cite journal |vauthors=Willert C, Spitzer C, Kusserow S, Runge U |title=Serum neuron-specific enolase, prolactin, and creatine kinase after epileptic and psychogenic non-epileptic seizures |journal=Acta Neurol. Scand. |volume=109 |issue=5 |pages=318–23 |date=May 2004 |pmid=15080857 |doi=10.1046/j.1600-0404.2003.00232.x |url=}}</ref><ref name="pmid4037754">{{cite journal |vauthors=Pritchard PB, Wannamaker BB, Sagel J, Daniel CM |title=Serum prolactin and cortisol levels in evaluation of pseudoepileptic seizures |journal=Ann. Neurol. |volume=18 |issue=1 |pages=87–9 |date=July 1985 |pmid=4037754 |doi=10.1002/ana.410180115 |url=}}</ref>
Epilepsy covers conditions with different aetiologies, natural histories and prognoses, each requiring different management strategies. A full medical diagnosis requires a definite categorisation of seizure and syndrome types.<ref>{{cite web | author=C P Panayiotopoulos and M Koutroumanidis | title=The significance of the syndromic diagnosis of the epilepsies | month=September | year=2005 | url=http://www.e-epilepsy.org.uk/pages/articles/show_article.cfm?id=33 | publisher=[[National Society for Epilepsy]]}}</ref>
** Elevated [[creatine phosphokinase]] (CPK)
** Elevated [[cortisol]]
** Elevated [[white blood cell count]]
** Elevated [[lactate dehydrogenase]]
** Elevated [[neuron-specific enolase]]
* For the first [[seizure]] episode, in order to find the etiology we should test for:<ref name="pmid18025394">{{cite journal |vauthors=Krumholz A, Wiebe S, Gronseth G, Shinnar S, Levisohn P, Ting T, Hopp J, Shafer P, Morris H, Seiden L, Barkley G, French J |title=Practice Parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society |journal=Neurology |volume=69 |issue=21 |pages=1996–2007 |date=November 2007 |pmid=18025394 |doi=10.1212/01.wnl.0000285084.93652.43 |url=}}</ref>
** [[Electrolyte|Electrolytes]]
** [[Glucose]]
** [[Calcium]]
** [[Magnesium]]
** [[Complete blood count]]
** [[Renal function tests]]
** [[Liver function tests]]
** [[Urinalysis]]
** [[Toxicology]] screens


==References==
==References==
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Latest revision as of 21:37, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

Laboratory findings consistent with the diagnosis of epilepsy include: Elevated creatine phosphokinase (CPK), elevated cortisol, elevated white blood cell count, elevated lactate dehydrogenase and elevated neuron-specific enolase.

Laboratory Findings

References

  1. Willert C, Spitzer C, Kusserow S, Runge U (May 2004). "Serum neuron-specific enolase, prolactin, and creatine kinase after epileptic and psychogenic non-epileptic seizures". Acta Neurol. Scand. 109 (5): 318–23. doi:10.1046/j.1600-0404.2003.00232.x. PMID 15080857.
  2. Pritchard PB, Wannamaker BB, Sagel J, Daniel CM (July 1985). "Serum prolactin and cortisol levels in evaluation of pseudoepileptic seizures". Ann. Neurol. 18 (1): 87–9. doi:10.1002/ana.410180115. PMID 4037754.
  3. Krumholz A, Wiebe S, Gronseth G, Shinnar S, Levisohn P, Ting T, Hopp J, Shafer P, Morris H, Seiden L, Barkley G, French J (November 2007). "Practice Parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society". Neurology. 69 (21): 1996–2007. doi:10.1212/01.wnl.0000285084.93652.43. PMID 18025394.

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