Evaluation of Cardiac Troponin Level Following Generalized Tonic-Clonic Seizure in Children; Cross-sectional Study

Abstract

Objectives: Cardiac troponin I (CTnI) is recognized as a proper marker for early detection of cardiac damage. Generalized tonic-clonic (GTC) seizures may lead to cardiac ischemia or myocardial injury associated with elevated CTnI. The present study aimed at evaluating the level of CTnI in children with status GTC seizures. Methods: 50 patients with GTC seizures and a normal cardiac function referred to Amirkabir Hospital, Arak, Iran were evaluated. The medical history of all patients was taken, and clinical examinations were performed. For all patients were performed Serum CTnI measurements, electroencephalography (EEG), electrocardiography (ECG), and echocardiography. Results: The patients’ mean age was 7.80 ± 4.01 years and 26 (52%) children were female (female: male ratio, 1.08). the mean duration of seizure was 31.54 ± 1.56 minutes. Abnormal EEG patterns were documented in 83 (86%) patients, while abnormal CT scan was not found in any of the patients. The mean level of CTnI was at the high end of the range in patients (57.02 ± 10.80 ng/mL). There was a positive correlation between serum CTnI and age (P = 0.001, R = 0.492). Also, the serum level of CTnI was significantly correlated with the onset of GTC seizure (R = 0.004, P = 0.001). Conclusion: The serum CTnI level exceeded the normal level in children with seizures. Therefore, cardiac monitoring of patients with status GTC seizures may be helpful in the ictal and postictal phases for evaluating cardiac injury, especially in children with risk factors for coronary diseases, such as Kawasaki disease, cardiomyopathy, or coronary anomalies.

Acute Myopericarditis after COVID-19 Vaccine in Teenagers

“…Our patient (case 1) had a level of 40 ng/mL which rapidly decreased to 11 ng/mL within 24 hours. Although troponin I is very specific marker for myocardial injury, there have been reports of troponin I elevation after a seizure [ 10 , 11 ]. Since our patient has history of Lennox-Gastaut syndrome, he might have had some seizures contributing to such an elevation.…”