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.