Elevated CK-MB mass and plasma brain-type natriuretic peptide concentrations following convulsive seizures in children and adolescents: possible evidence of subtle cardiac dysfunction.
OBJECTIVE
To evaluate the presence of myocardial injury during convulsive seizures in children and adolescents by determining serum concentrations of cardiac troponin I (cTnI), creatine kinase-MB mass (CK-MB mass), and plasma brain-type natriuretic peptide (BNP).


METHODS
Thirty-one children (20 boys; mean age, 6.6 +/- 5.34 years) with convulsive seizures and 50 healthy children were enrolled. Serum cTnI, CK-MB mass, and plasma BNP concentrations were analyzed 12 h after the seizure and repeated 7 days thereafter in the patient group and obtained one time in the control group.


RESULTS
The difference between serum concentrations of cTnI obtained 12 h and 7 days after the seizure was not statistically significant. cTnI levels 12 h postictal and those in control subjects also were not significantly different. CK-MB mass and BNP at the 12th h were higher than those obtained on the 7th day (p < 0.05 and p < 0.001, respectively). Children with seizures had increased levels of CK-MB mass and BNP 12 h after seizure than control subjects (p < 0.05 and p < 0.001, respectively). The results of electrocardiography (ECG) recordings, which were obtained up to 30 min after seizure activity, were completely normal in patients with seizure.


CONCLUSIONS
Normal cTnI levels are not indicative of overt myocardial necrosis in patients with seizures. However, markedly elevated BNP concentrations together with elevated CK-MB mass levels do suggest subtle cardiac dysfunction in patients with seizure, and further large-scale studies are warranted.
Alehan
Füsun
F
Department of Pediatrics, Division of Child Neurology, Baskent University Faculty of Medicine, Bahcelievler, Ankara, Turkey. falehan@hotmail.com
Erol
Ilknur
I
Cemil
Tuba
T
Bayraktar
Nilüfer
N
Ogüs
Ersin
E
Tokel
Kürsad
K
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D052279:Creatine Kinase, MB Form / Q000097:blood*; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods; D007223:Infant; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012189:Retrospective Studies; D012640:Seizures / Q000097:blood*; D018709:Statistics, Nonparametric; D013997:Time Factors; D020107:Troponin T / Q000097:blood
D020107:Troponin T; D020097:Natriuretic Peptide, Brain; D052279:Creatine Kinase, MB Form