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Evaluation of Hematological and Biochemical Parameters in Patients Presenting to the Emergency Department with Epileptic Seizure

Year 2023, Volume: 18 Issue: 2, 110 - 116, 12.07.2023
https://doi.org/10.17517/ksutfd.1310817

Abstract

Objective: It was aimed to review the laboratory tests (blood gas, hemogram, biochemistry and prolactin values) that can be used together with symptoms
and findings in the diagnosis of epileptic seizures in epileptic patients in the light of current literature.
Materials and Methods: The study is a descriptive epidemiological study. The study was done prospectively. Patients aged 18 years and over who had
epileptic seizures in the emergency department and applied to the emergency department after an epileptic seizure between 01.01.2022 and 31.05.2023 were
included in the study. Blood gas, hemogram, biochemistry and prolactin values were analyzed in patients with epileptic seizures.
Results: Glucose, immature granulocyte and prolactin levels were found to be significantly higher in patients with epileptic seizures. Blood lactate levels
were found to be high but not significant. No significant difference was found in blood carbon dioxide level, blood pH level, blood electrolyte level, RDW,
MCV, MPV, NLR and PLO values, which are among the other blood tests performed in our study. Blood prolactin levels, leukocyte and lymphocyte levels
were found to be significantly higher in female patients who had epileptic seizures compared to male patients; Calcium and magnesium values were found
to be significantly lower than male patients.
Conclusion: A detailed history of epileptic seizures and a careful neurological examination in emergency services will not only enable patients to reach the
correct diagnosis and treatment, but also prevent many negative consequences of misdiagnosis/treatment. New biomarkers and therapeutic interventions will
help to accurately diagnose and treat epileptic seizures and reduce long-term morbidity and death.

References

  • Balal M, Demir T, Bozdemir H. Birinci basamak sağlık hizmetlerinde epileptik nöbet ve non epileptik psikojen nöbet ayırıcı tanısı. TJFM&PC, 2016;10(2):105-108.
  • Arıkanoğlu A. Epileptik nöbet ve psödonöbet ayırıcı tanısı. Klinik ve Deneysel Araştırmalar Dergisi 2011;2(3):330-334.
  • Çakıl D, İnanır S, Baykan H, Aygün H, Kozan R. Epilepsi ayırıcı tanısında psikojeniknon-epileptik nöbetler. Göztepe Tıp Dergisi 2013;28(1):41-47.
  • Bodde NM, Brooks JL, Baker GA, Boon PA, Hendriksen JG, Mulder OG et al. Psychogenicnon-epileptic seizures-definition, etiology, treatment and prognostic issues: A criticalreview. Seizure 2009;18(8):543-553.
  • Ioannis KA, Georgia D, Montouris B, Charitomeni PC, Marta SLD, Kimford J et al. Patient and care giver quality of life in psychogenicnon-epileptic seizures compared to epileptic seizures. Seizure 2014;23:47–54.
  • Yoldas MA, Hanci F, Dincel GK, Bekdas M. The predictive role of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in children with simple febrile seizures. Exp Biomed Res 2021;4(3):198-205.
  • Güneş M, Büyükgöl H. Relationship between generalized epileptic seizure and neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and neutrophil mediated inflammation. Int J Neurosci. 2020;130(11):1095-1100.
  • Hosseini S, Mofrad AME, Mokarian P, Nourigheimasi S, Azarhomayoun A, Khanzadeh S et al. Neutrophil to lymphocyte ratio in epilepsy: A systematic review. Mediators Inflamm. 2022;2022:4973996.
  • Chen DK, So YT, Fisher RS. Use of serum prolactin in diagnosing epileptic seizures: Report of the Therapeutics and Technology Assesment Subcomittee of the American Academy of Neurology. 2005;65:668-675.
  • Eroglu T, Aydin Turkoglu S, Bolac ES, Yıldız S, Yıldız N. Hemogram parameters in epilepsy may be indicators of chronic inflammation and hypoxemia. J Neurol Clin Neurosci. 2017;1(1):17–20.
  • Gontko-Romanowska K, Żaba Z, Panieński P, Steinborn B, Szemień M, Łukasik-Głębocka M et al. The assessment of laboratory parameters in children with fever and febrile seizures. Brain Behav. 2017;7(7):e00720.
  • Kiviranta T, Airaksinen EM. Low sodium levels in serum are associated with subsequent febrile seizures. Acta Paediatr. 1995;84(12):1372-1374.
  • Zifman E, Alehan F, Menascu S, Har-Gil M, Miller P, Saygi S et al. Clinical characterization of gastroenteritis-related seizures in children: impact of fever and serum sodium levels. J Child Neurol. 2011;26(11):1397-1400.
  • Karceski S. Acute symptomatic seizures and systemic illness. Continuum (Minneap Minn). 2014;20:614-623.
  • Costea RM, Maniu I, Dobrota L, Neamtu B. Stress hyperglycemia as predictive factor of recurrence in children with febrile seizures. Brain Sci. 2020;10(3):131.

Acil Servise Epilepsi Nöbeti ile Başvuran Hastalarda Hematolojik ve Biyokimyasal Parametrelerin Değerlendirilmesi

Year 2023, Volume: 18 Issue: 2, 110 - 116, 12.07.2023
https://doi.org/10.17517/ksutfd.1310817

Abstract

Amaç: Epilepsi nöbeti geçiren hastalarda semptom ve bulgular ile beraber doğru tanı koymada kullanılabilecek laboratuar testlerinin (kan gazı, hemogram,
biyokimya ve prolaktin değerleri) güncel literatür bilgisi ışığında gözden geçirilmesi amaçlandı.
Gereç ve Yöntemler: Çalışma tanımlayıcı tipte bir epidemiyolojik araştırmadır. Çalışma prospektif olarak yapıldı. 01.01.2022–31.05.2023 tarihleri arasında
acil serviste epilepsi nöbeti geçirmiş ve acil servise epilepsi nöbeti sonrası başvurmuş 18 yaş ve üstü hastalar çalışmaya dâhil edildi. Epilepsi nöbeti geçiren
hastalarda kan gazı, hemogram, biyokimya ve prolaktin değerleri incelendi.
Bulgular: Epilepsi nöbeti geçiren hastalarda postiktal ivedilikle tetkik edilen glikoz, immatür granülosit ve prolaktin düzeyleri anlamlı derecede yüksek
bulundu. Kan laktat düzeyleri yüksek saptandı fakat anlamlı bulunmadı. Çalışmamızda bakılan diğer kan tahlillerinden olan kan karbondioksit düzeyi, kan
pH düzeyi, kan elektrolit düzeyi, RDW, MCV, MPV, NLO ve PLO değerlerinde ise anlamlı bir fark saptanmadı. Epilepsi nöbeti geçiren kadın hastalarda kan
prolaktin düzeyi, lökosit ve lenfosit değerleri erkek hastalara göre anlamlı derecede yüksek saptandı; kalsiyum ve magnezyum değerleri ise erkek hastalara
göre anlamlı derecede düşük saptandı.
Sonuç: Acil servislerde ayrıntılı epilepsi nöbet öyküsü ve dikkatli bir nörolojik muayene, hastaların doğru tanı ve tedaviye ulaşmalarını sağladığı gibi, yanlış
tanı/tedavinin getireceği pek çok olumsuz sonuçları da engelleyecektir. Yeni biyobelirteçler ve terapötik müdahaleler, epilepsi nöbetine doğru tanı koymaya
ve tedavi etmeye yardımcı olacak, uzun vadeli morbidite ve ölümü azaltacaktır.etine doğru tanı koymaya ve tedavi etmeye yardımcı olacak, uzun vadeli morbidite ve ölümü azaltacaktır.

References

  • Balal M, Demir T, Bozdemir H. Birinci basamak sağlık hizmetlerinde epileptik nöbet ve non epileptik psikojen nöbet ayırıcı tanısı. TJFM&PC, 2016;10(2):105-108.
  • Arıkanoğlu A. Epileptik nöbet ve psödonöbet ayırıcı tanısı. Klinik ve Deneysel Araştırmalar Dergisi 2011;2(3):330-334.
  • Çakıl D, İnanır S, Baykan H, Aygün H, Kozan R. Epilepsi ayırıcı tanısında psikojeniknon-epileptik nöbetler. Göztepe Tıp Dergisi 2013;28(1):41-47.
  • Bodde NM, Brooks JL, Baker GA, Boon PA, Hendriksen JG, Mulder OG et al. Psychogenicnon-epileptic seizures-definition, etiology, treatment and prognostic issues: A criticalreview. Seizure 2009;18(8):543-553.
  • Ioannis KA, Georgia D, Montouris B, Charitomeni PC, Marta SLD, Kimford J et al. Patient and care giver quality of life in psychogenicnon-epileptic seizures compared to epileptic seizures. Seizure 2014;23:47–54.
  • Yoldas MA, Hanci F, Dincel GK, Bekdas M. The predictive role of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in children with simple febrile seizures. Exp Biomed Res 2021;4(3):198-205.
  • Güneş M, Büyükgöl H. Relationship between generalized epileptic seizure and neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and neutrophil mediated inflammation. Int J Neurosci. 2020;130(11):1095-1100.
  • Hosseini S, Mofrad AME, Mokarian P, Nourigheimasi S, Azarhomayoun A, Khanzadeh S et al. Neutrophil to lymphocyte ratio in epilepsy: A systematic review. Mediators Inflamm. 2022;2022:4973996.
  • Chen DK, So YT, Fisher RS. Use of serum prolactin in diagnosing epileptic seizures: Report of the Therapeutics and Technology Assesment Subcomittee of the American Academy of Neurology. 2005;65:668-675.
  • Eroglu T, Aydin Turkoglu S, Bolac ES, Yıldız S, Yıldız N. Hemogram parameters in epilepsy may be indicators of chronic inflammation and hypoxemia. J Neurol Clin Neurosci. 2017;1(1):17–20.
  • Gontko-Romanowska K, Żaba Z, Panieński P, Steinborn B, Szemień M, Łukasik-Głębocka M et al. The assessment of laboratory parameters in children with fever and febrile seizures. Brain Behav. 2017;7(7):e00720.
  • Kiviranta T, Airaksinen EM. Low sodium levels in serum are associated with subsequent febrile seizures. Acta Paediatr. 1995;84(12):1372-1374.
  • Zifman E, Alehan F, Menascu S, Har-Gil M, Miller P, Saygi S et al. Clinical characterization of gastroenteritis-related seizures in children: impact of fever and serum sodium levels. J Child Neurol. 2011;26(11):1397-1400.
  • Karceski S. Acute symptomatic seizures and systemic illness. Continuum (Minneap Minn). 2014;20:614-623.
  • Costea RM, Maniu I, Dobrota L, Neamtu B. Stress hyperglycemia as predictive factor of recurrence in children with febrile seizures. Brain Sci. 2020;10(3):131.
There are 15 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration, Health Services and Systems (Other)
Journal Section Araştırma Makaleleri
Authors

Muhammed Semih Gedik 0000-0003-3854-4794

Ali İhsan Kilci 0000-0003-0029-3942

Hakan Hakkoymaz 0000-0002-8568-8283

Ömer Faruk Küçük 0000-0002-2247-6785

Nuri Mehmet Basan 0000-0003-3179-8150

Muhammed Ali Güler 0000-0003-0375-5268

Caner Akufuk 0000-0003-4624-0803

Early Pub Date July 10, 2023
Publication Date July 12, 2023
Submission Date June 6, 2023
Acceptance Date June 14, 2023
Published in Issue Year 2023 Volume: 18 Issue: 2

Cite

AMA Gedik MS, Kilci Aİ, Hakkoymaz H, Küçük ÖF, Basan NM, Güler MA, Akufuk C. Acil Servise Epilepsi Nöbeti ile Başvuran Hastalarda Hematolojik ve Biyokimyasal Parametrelerin Değerlendirilmesi. KSU Medical Journal. July 2023;18(2):110-116. doi:10.17517/ksutfd.1310817