Prehospital capillary lactate in children differentiates epileptic seizure from febrile seizure, syncope, and psychogenic nonepileptic seizure.

Abstract

PURPOSE:

The aim of the study was to examine prehospital capillary lactate in children as a diagnostic biomarker to differentiate epileptic seizures from febrile seizures, syncope, and psychogenic nonepileptic seizures (PNES).

METHODS:

Capillary lactate concentrations taken in a pediatric prehospital setting within 2 h of the paroxysmal event were compared retrospectively between patients with epileptic seizure, febrile seizure, syncope, and PNES, based on the final diagnosis from the hospitalization report.

RESULTS:

One hundred and two patients were included, 53 (52%) with epileptic seizures, 41 (40%) with febrile seizures, and 8 (8%) with syncope or PNES. Capillary lactate in patients with a final diagnosis of epileptic seizure was significantly increased in comparison to the concentrations in patients with febrile seizure (p < 0.0007) and in comparison to the concentrations in patients with syncope or PNES (p < 0.0204). The area under the ROC-curve was 0.71 (95% CI 0.61-0.80). For a cutoff concentration of prehospital capillary lactate >3.9 mmol/l (Youden index), the sensitivity was 49% and the specificity 92%.

CONCLUSION:

Prehospital capillary lactate concentrations are a useful tool for differentiating the nature of a paroxysmal event in children.

• Authors: Ethan Isaac Brody, Mathieu Genuini, Stéphane Auvin, Noella Lodé, Stéphanie Rose Brunet
• Journal: Epilepsy & behavior : E&B (Epilepsy Behav) Vol. 127 Pg. 108551 (02 2022) ISSN: 1525-5069 [Electronic] United States
• PMID: 35051869 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Elsevier Inc. All rights reserved.

Chemical References

• Lactic Acid

Topics

• Child
• Diagnosis, Differential
• Electroencephalography
• Emergency Medical Services
• Humans
• Lactic Acid
• Psychogenic Nonepileptic Seizures
• Retrospective Studies
• Seizures (diagnosis, psychology)
• Seizures, Febrile (complications, diagnosis)
• Syncope (diagnosis)