Evidence map›Paper›PMID 37821955›Full record

ReviewNeurological research and practice2023

The role of creatine kinase in distinguishing generalized tonic-clonic seizures from psychogenic non-epileptic seizures (PNES) and syncope: a retrospective study and meta-analysis of 1300 patients.

Ramy Abdelnaby, Anas Elgenidy, Jan Heckelmann, Mahmoud Mostafa Bedewy, Ahmed Samy Shabib, Mohamed Ayman Ebrahim, Khaled Abdelmoneim Elmenawi, Imene Maallem, Merna Wagih Youssef, Abdelrahman M Attia and 3 more

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PubMed Full text at PMC Publisher
In one paragraph

Review in Neurological research and practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
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  3. Article
  4. Observational
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 7 institutions in 3 countries.

Ramy Abdelnaby *Department of Neurology, RWTH Aachen University, Aachen, Germany. rabdelnaby@ukaachen.de.ORCID http://orcid.org/0000-0001-5161-2195
Anas Elgenidy *Faculty of Medicine, Cairo University, Cairo, Egypt.
Jan HeckelmannDepartment of Neurology, RWTH Aachen University, Aachen, Germany.
Mahmoud Mostafa BedewyFaculty of Medicine, Cairo University, Cairo, Egypt.
Ahmed Samy ShabibFaculty of Medicine, Mansoura University, Mansoura, Egypt.
Mohamed Ayman EbrahimFaculty of Medicine, Cairo University, Cairo, Egypt.
Khaled Abdelmoneim ElmenawiFaculty of Medicine, Cairo University, Cairo, Egypt.
Imene MaallemFaculté de Pharmacie, 23 Avenue Maquis du Grésivaudan, 38700, La Tronche, Grenoble, France.
Merna Wagih YoussefFaculty of Medicine, Alexandria University, Alexandria, Egypt.
Abdelrahman M AttiaFaculty of Medicine, Cairo University, Cairo, Egypt.
Mostafa Hossam Moawad *Faculty of Pharmacy, Clinical Department, Alexandria University, Alexandria, Egypt.
Khaled Ashraf Mohamed *Faculty of Medicine, Cairo University, Cairo, Egypt.
Ahmed Gaballa *Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Campus Bielefeld- Bethel, Bielefeld, Germany.
Cairo University · EGRWTH Aachen University · DEAlexandria University · EGAmer Sports (France) · FRBielefeld University · DEMansoura University · EGSuez Canal University · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

aimAs the clinical differentiation between epileptic seizures, psychogenic non-epileptic seizures (PNES), and syncope depends mainly on a detailed report of the event, which may not be available, an objective assessment of a potential biochemical analysis is needed. We aimed to investigate whether serum creatine kinase (CK) could be used to differentiate epileptic seizure from PNES and syncope and to assess the strength of evidence present.

methodsWe directed a retrospective cohort study coupled with a systematic review and meta-analysis of studies that measured CK in patients with epilepsy, PNES, syncope, and healthy controls.

resultsThe cohort study, which traced 202 patients, showed that the CK level was significantly higher 48 h after the event in the epilepsy group versus patients with syncope (p < 0.01) Along with 1086 patients obtained through a database search for meta-analysis, CK level compared to different types of seizures from PNES was higher in epileptic seizure patients with a mean difference of 568.966 mIU/ml (95% CI 166.864, 971.067). The subgroup analysis of CK showed that it was higher in GTCS compared to syncope with a mean difference of 125.39 mIU/ml (95% CI 45.25, 205.52). DISCUSSION: Increased serum levels of CK have been associated mainly with epileptic seizures in relation to non-epileptic events. However, further studies would try to explore the variation in measurements and any other potential diagnostic marker.

conclusionThe cohort study shows that the CK level in epilepsy seizures is higher after 48 h from the event compared to syncope. Moreover, the meta-analysis results show the present diagnostic utility of CK and its importance to be used in accordance with a detailed report of the event.

Indexed as

Creatine kinaseEpileptic seizuresGeneralized tonic-colonic seizurePsychogenic non-epileptic seizuresSyncope

Identifiers

PMID37821955
PMCPMC10568853
OpenAlexW4387525745

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.