Postictal serum creatine kinase in the diagnosis of seizure disorders
E. Wyllie, H. Lueders, C. Pippenger and F. VanLente
We prospectively correlated daily serum creatine kinase (CK) levels with
the occurrence of different types of epileptic and nonepileptic seizures
documented by video EEG recording in 22 hospitalized patients. Prolonged
postictal CK elevations, 8.0 to 19.2 times baseline, were seen following
six (15%) of 41 generalized tonoclonic seizures. No CK elevations were seen
following 147 complex partial, focal motor, absence, and tonic seizures or
55 psychogenic seizures, 89% of which involved vigorous muscular activity.
Six of 12 patients with generalized tonoclonic seizures had postictal CK
elevations compared with none of six patients with psychogenic seizures and
none of 15 patients with complex partial, focal motor, absence, and tonic
seizures. Thus, postictal CK determination can serve as an adjunctive test
for differentiation between psychogenic and epileptic generalized
tonoclonic seizures.
