Lactate as a diagnostic marker in transient loss of consciousness
O Matz, C Zdebik, S Zechbauer, L Bündgens, J Litmathe, K Willmes, J B Schulz, M Dafotakis, O Matz, C Zdebik, S Zechbauer, L Bündgens, J Litmathe, K Willmes, J B Schulz, M Dafotakis
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.
Keywords: Diagnostic marker; Lactate; Loss of consciousness; Seizure; Syncope.
Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
Source: PubMed