Lactate Clinical Trial
Official title:
Impact of Early Lactate Dosage Compared to CK for Diagnosis of a Suspected Seizure, on Patient Admitted to an Emergency Unit
Defining the origin of a seizure remains a difficult diagnosis. The presence of witness is
not systematic, the clinical examination can be little contributory, and the delay
recommended by the FSN is often surpassed for the realization of Creatine kinase (4h). In
the event of a suspected seizure, an initial blood test with Creatine kinase and Lactates is
often done on admission of the patient in other words before the 4hours delay.
It seems interesting to harmonize the practices, to limit the patient wait in the
emergencies for a deferred dosage of CK at 4 hours from the seizure and to identify an early
biological marker.
Objectives:
To evaluate the value of blood CK and Lactate dosage in emergency procedures in the
diagnosis of generalized seizures.
We propose to carry out a prospective, observational, monocentric study at the CHU of
Clermont-Ferrand. This is a descriptive analysis of the kinetics of the Creatine kinase and
Lactates rates collected at the admission of a patient consulting for strong suspicion of
convulsive seizure, and at 4 hours from the generalized seizure.
A patient consulting the emergency department for suspected seizure will have an usual blood
test at the admission in this context with notably ionogram, fasting glucose, venous
gasometry. As the CHU purchased a venous and arterial gasometry reader for the emergency
department, blood ionogram, Hb, lactates, HCO3-, pH are collected without delay.
The Creatine kinase dosage will be collected in the usual way as a "tube bottom".
As recommended by the French Society of Neurology, a new sample will be collected at 4 hours
of seizure for a dosage of Creatine kinase. The determination of the lactates will be based
on a "tube bottom".
It is the emergency practitioner who will decide whether or not to include the patient in
the descriptive study, assisted by a standardized survey, enumerating the high probability
of generalized seizure orientation characteristics (patient history, treatments including
antiepileptics, anamnesis, witnesses presence, evocative clinic) The study only recruited
cases of strong suspicion of generalized seizure, beginning less than 4 hours to compare the
kinetics of Creatine kinase and Lactates at admission and 4 hours of the generalized
seizure.
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