Plasma Brain-Type Natriuretic Peptide Level Following Seizure and Syncope: Pilot Study

Abstract

Background and Purpose:To explore the clinical feasibility of plasma brain-type natriuretic peptide (proBNP) level to differentiate the two major causes of transient unconsciousness, seizure and vasovagal syncope (VVS) in adult patients.Methods:ProBNP levels were evaluated within 24 hours following attack in patients who had experienced a transient episode of unconsciousness. For confirmatory diagnosis, clinical history was reviewed thoroughly and several work-ups including electroencephalography and cerebral imaging and tilt-table test, were performed in cases of putative VVS, as a part of routine clinical approaches.Results:According to various relevant evaluations, 15 patients were diagnosed as seizure (age, 40.3±13.8 years) and 12 patients were VVS (age, 38.1±17.1 years). Plasma concentrations of pro-BNP were not different between two groups (p=0.714). Median level was 34.3 pg/mL (interquartile range: 12.9–91.1) in post-seizure group and 32.3 pg/mL (interquartile range 8.9–77.4) in post-VVS group. Additionally, it was not correlated with the sampling times within 24 hours after the episodes.Conclusions:The plasma level of pro-BNP has a limited clinical value in differentiating seizure and vasovagal syncope in adults. However, the more validated results with a large population should be sought in the future studies to confirm its value.

cTnI, BNP and CRP profiling after seizures in patients with drug-resistant epilepsy

“…Until now, few studies addressed BNP levels after epileptic seizures, and, although being prospective, they included only patients with GTCS [8], patients admitted to the emergency room/center [10,15], or only children [10]. In these studies, Kyung-Il Park [15] failed to show any differences in NT-proBNP between the seizure and the vasovagal syncope groups, but his study comprised merely 12 patients with syncope and 15 with seizures, and measurements were made up to 24 h after each episode. Rauchenzauner et al [10] found higher levels of BNP in children with GTCS and febrile convulsions.…”

“…In patients admitted to the emergency room, Rauchenzauner et al [10] reported elevated plasma NT-proBNP levels after seizures in children with tonic-clonic seizures or febrile convulsions, but not in those with partial motor seizures or syncope, while Park et al [15] reported similar levels of pro-BNP in patients with syncope and patients with seizures.…”

“…Until now, most studies in this field have used different methodologies, were mainly retrospective [4,5,7], and/or included only patients admitted to emergency rooms [4,6,7,10,14,15].…”

The role of postictal laboratory blood analyses in the diagnosis and prognosis of seizures

“…A study that systematically assessed NT-pro-BNP after seizures in 18-60 year-old patients without prior heart disease who were admitted to the ER <24 h after a transient loss of consciousness, showed no difference between 12 syncope-and 15 ES-patients. The authors did not regard NT-pro-BNP as a suitable marker in distinguishing syncope from ES [118]. More information on cardiac markers is provided in Section 3.3.2.…”

Evaluation of the Pharmacotherapeutic Pattern for Treating Schizophrenia in Bangladesh

“…Anticholinergic drugs are being prescribed for symptomatic treatment of Parkinson disease for over a century and they are still trusted by physicians. For patients with psychosis and schizophrenia, anticholinergics are primarily used to counter the extrapyramidal side effects or prevent side effects induced by antipsychotics [27]. Extrapyramidal side effects such as Parkinsonism are believed to be the unavoidable result of antipsychotic efficacy conferred by dopamine D2 receptor blockade [28].…”