Usefulness of Serum NT-proBNP in Diagnosis of Generalized Seizures in Egyptian Children

Background:

 Seizures may occur in as many as 1% of children. The most urgent type of seizures is generalized tonic-clonic seizures (GTCS). N-terminal prohormone of brain natriuretic peptide (NT‐proBNP) has been considered as a promising biomarker in numerous acute illnesses. We aimed to evaluate usefulness of NT‐proBNP for diagnosis of generalized seizures in children. 

Materials and Methods:

 This prospective case control study was conducted upon 80 children who were classified into four groups; Group I: included 20 patients with idiopathic generalized epileptic seizures. Group II: included 20 patients with focal epileptic seizures. Group III: included 20 patients with febrile seizures. Group IV: included 20 apparently healthy, age and sex matched children as a normal control. Complete blood count (CBC), blood chemistries, including random blood glucose, calcium, sodium, C-reactive protein (CRP) level, serum prolactin and NT‐proBNP were performed for all children.

Results:

 Our results revealed significant increase of both prolactin and NT‐proBNP in generalized epileptic and febrile seizure groups than in focal epileptic and control groups (p< 001). The ROC curve analysis showed NT‐proBNP, at a cut-off value of > 384 pg/ml, sensitivity (90 %), and specificity (70.2%) which was near the results of prolactin at a cut-off value> 25.9 ng/ml, and showed sensitivity (95.1%), and specificity (71.3%). 

Conclusion:

 Based on the results, NT‐proBNP increase in generalized seizures either epileptic or febrile; and may be a promising marker to adjust the diagnosis of it at the emergency setting, when history and clinical presentation are equivocal.