Role of Inflammation and Serum Creatine Phospho Kinase in Seizures

Background and Objectives: Epilepsy which is a disorder with an extensive variability of symptomatology and multifactorial origins is categorized by emergent and recurrent seizures. Numerous studies showed that seizures are triggered by hyperactivity of the neurons of the brain which may be atypical and synchronous. Our study was aimed to find out the association of inflammation in terms of total leukocyte count (TLC) and serum creatine phosphokinase (CPK) concentration in epilepsy and their comparison with pseudo-seizures and healthy controls. Methodology: We conducted this study in Mayo Hospital, Lahore with the collaboration of the Physiology Department of King Edward Medical University, Lahore after approval from Advanced Studies and Research Board of KEMU, Lahore. The sample size was ninety and they were divided equally into three groups, 30 patients of GTCS, 30 patients with a history of pseudoseizures and 30 healthy subjects of comparable age. p< 0.001 was taken as significant. Statistical analyses were done using SPSS 21. Results: Mean total leukocyte count (TLC) in Pseudo-seizures groups was 8216.3 ± 2195.8 cu.mm, in the epileptic group was 13219.9 ± 2686.8 cu.mm and in the control group, the mean TLC was 6832.1 ± 1154.9 cu.mm. Mean serum CPK in pseudo-seizure groups was 130.1 ± 74.3 IU/100 ml, in the epileptic group was 257.7 ± 24.6 IU/100 ml and in the control group, the mean CPK was 79.9 ± 27.7 IU/100 ml. Conclusion: Total leukocyte count (TLC) and CPK were higher in the epileptic group as compare to the pseudo-seizure groups as well as the control group. Elevated WBC levels may be a result of continuing inflammatory progressions in the pathogenesis of epilepsy. Therefore it was concluded that serum CPK and TLC may serve as a differentiating marker between epileptic generalized tonic-clonic seizures (GTCS) and pseudo seizers.

Correlation of serum creatine phosphokinase and serum cholinesterase in organophosphate poisoning in children

Background: Organophosphate (OP) poisoning is one of the most common pesticide poisoning in India in adolescents because of its easy availability. Serum pseudocholinesterase levels are commonly used to assess the severity and to know the prognosis in OP compound poisoning. Serum creatine phosphokinase (CPK) levels is another lab parameter which gets deranged in OP poisoning and has been tried in adults to assess the severity and to know the prognosis.'Authors objective was to study the correlation of serum pseudocholinesterase and serum CPK in organophosphate poisoning at admission and to compare outcome with serum CPK levels.Methods: All the children in the age group of 1 month to 18 yrs, who were admitted with the history of suspected OP compound poisoning were enrolled for the study. Estimation of cholinesterase and CPK levels were done at admission and after 1 week. Patients were categorised in to latent, mild, moderate and severe cases based on the S. Cholinesterase levels. These values were analysed to see the correlation.Results: Among 34 OP poisoning cases,13(38%) were males and 21(62%) were females. Mean age of study population was12.6+4.25 yrs. The median CPK values in latent, mild, moderate and severe cases were 121.5 IU/L,276.5 IU/L, 308IU/L and 467IU/L respectively (p=0.015). Spearman's rho Correlation coefficient was -0.522 between S. Cholinesterase and S CPK at admission which was significant. The median serum CPK level after 1week in non survivors was 2498.0IU/L and in survivors was 201.0IU/L (p0.014).Conclusions: There was a strong negative relationship between serum cholinesterase and serum CPK at admission in OP poisoning. Follow up values at 1 week showed that significantly high serum CPK and low cholinesterase, which was also significant and was associated with mortality.

Effect of Atypical Antipsychotics, Risperidone on Serum Creatine Phosphokinase / 대한정신약물학회지

OBJECTIVES: This prospective study was designed to investigate the effect of serotonergic atypical antipsychotics on serum creatine phosphokinase. METHOD: The subjects were 60 inpatients who were medicated risperidone and nemonapride, atypical antipsychotics. The symptoms of NMS such as fever and muscle rigidity and the level of CRK of all subjects were assessed on the 5th, 10th, 20th, and 30th medication day. RESULTS: Sociodemographic variables, such as sex and mean age and number of intramuscular injection were not different between the risperidone and the nemonapride group. Maximum dosage of antipsychotics (chlorpromazine equivalent) was significantly higher in the nemonapride group. Fever and muscle rigidity were not different between two groups (p>0.05). The change of serum creatine phosphokinase was significantly higher in the risperidone group than the nemonapride group (p<0.05). CONCLUSIONS: Serum CRK showed a significant increase in risperidone than nemonapride group. Such a finding is primarily caused by the effect of atypical antipsychotics mediating serotonergic effects. It is not recommanded to stop the medication by misunderstanding the effect as a prodrome symptom of NMS.

The Relationship between Serum Creatine Phosphokinase Activity and Labor Intensity / 日本農村医学会雑誌

The relationship between serum creatine phosphokinase (CPK) activity and labor strength was examined.<BR>Our epidemiological study showed thar the serum CPK activity in a group of men who worked over ten hours was significantly higher than that in the other groups who worked less than ten hours. In women, the serum CPK activity in a group who worked over seven hours was significantly higher than that in the other groups. The serum CPK activity in fishermen was significantly higher than that in those engaged in other than fishery.<BR>In a laboratory study, test subjects were divided into 3 groups to perform 3 types (30%, 50%, 70% of VO<SUB>2max</SUB>) of exercise for 6 weeks. A rise in the serum CPK activity was noted in every group during exercise. The mean increase for these groups were 44.0 %, 48.1 % and 67.9 %, respectively.

A study of serum CK-BB activity as a diagnostic method and a predictor of neurologic outcome in asphyxiated infants

Asphyxia is the most important perinatal cause of neurologic morbidity in infants. Recently, elevated levels of CK-BB have been demonstrated in serum after asphyxic insult in infants. To evaluate the possibility of using serial measurements of CK-BB activity as a diagnostic method and a predictor of neurologic outcome in asphyxiatic infants. We studied CK-BB activity in serum of asphyxiated infants (16 preterm babies, 41 term babies) and healthy infants (11 preterm babies, 12 term babies) from birth (cord) to 5 days of serially. The results were as follows 1) Serum CK-BB activites (cord 76.0IU/L, 12 hours 34.1 IU/L, 1 day 22.4 IU/L, 2 days 8.2 IU/L) of asphyxiated preterm infants were much higher than those (cord 4.4IU/L, 12 hours 2.4IU/L, 1 day 1.6 IU/L, 2 days 1.1 IU/L) of healthy preterm infants, but there were no significant differences (P values>0.05). 2) Serum CK-BB activities (cord 59.0 IU/L, 12 hours 23.6 IU/L, day 17.6 IU/L) of asphyxiated term infants were significantly higher than those (cord 2.4 IU/L, 12 hours 2.7 IU/L, 1 day 0.4 IU/L) of healthy term infants (P values0.05) 4) Serum CK-BB activity (131.7 IU/L) at birth (cord) of asphyxiated term infants who showed late neurologic deficits was significantly higher than that (49.8 IU/L) of asphyxiated term infants who did not show late neurologic deficits (P value<0.05) In conclusion, it is suggested that serial measurement of CK-BB activity in serum of asphyxiated term infants from birth (cord) to 1 day of age is an available test for diagnosis of neonatal asphyxia and for a prediction of neurologic outcome of neonatal asphyxia.