ABSTRACT
Background: Motor signs accompanying seizures have been
considered to result in over-exertion of muscles and have the ability to
cause elevated levels of serum creatine kinase (CK). There were no
previous studies on the treatment of seizure-induced elevated CK. We
summarized the characteristics and treatments of six patients with
significant elevation of CK after seizure onset.
Case report: There were four males and two females, the age
range was 16 to 68 years. The CK levels were greater than 5,000 U/L in
five of the six patients and the highest CK level was 39,300 U/L. All
patients exhibited an estimated glomerular filtration rate (eGFR)
< 90 ml/min/1.73m2. No patient developed
renal failure or required continuous renal replacement therapy. We
determined that serial assessment of CK, myoglobin, eGFR, and
electrolytes should be performed in patients following seizures.
Furthermore, fluid resuscitation, urine alkalization, and diuretic
agents should be administrated when CK are significantly elevated after
seizure onset.
Conclusions: Serial assessment of CK levels after seizures
should be performed, especially when the patient experiences electrolyte
disorders. Fluid resuscitation, urine alkalization, and diuretic agents
also should be administrated to patients when they exhibit a
significantly elevated CK or myoglobin after seizures.
Keywords: Creatine kinase, Seizures, HyperCKemia, Acute kidney
injury, Treatment