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LETTER TO EDITOR
Year : 2014  |  Volume : 62  |  Issue : 4  |  Page : 441

Elevated serum creatine kinase due to nocturnal seizure


Department of Neurosurgery, Tokorozawa Central Hospital, Saitama, Japan

Date of Web Publication19-Sep-2014

Correspondence Address:
Hiroshi Nawashiro
Department of Neurosurgery, Tokorozawa Central Hospital, Saitama
Japan
Hiroshi Nawashiro
Department of Neurosurgery, Tokorozawa Central Hospital, Saitama
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.141234

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How to cite this article:
Nawashiro H, Nawashiro H. Elevated serum creatine kinase due to nocturnal seizure. Neurol India 2014;62:441

How to cite this URL:
Nawashiro H, Nawashiro H. Elevated serum creatine kinase due to nocturnal seizure. Neurol India [serial online] 2014 [cited 2020 Oct 25];62:441. Available from: https://www.neurologyindia.com/text.asp?2014/62/4/441/141234


A previously healthy 25-year-old man complained of nightmares and chest pain in the morning. The result of his physical and neurological examination was normal except for a mild tenderness in the chest wall. Chest x-ray and electrocardiographic screening were normal. Blood chemistry revealed increased creatine kinase (CK), which was further determined to be muscle-specific CK (CK-MM). Sleep electroencephalography showed spikes over the right hemisphere. Magnetic resonance imaging (MRI) of the brain revealed an abnormal hyperintensity area in the right mesial temporal lobe [[Figure 1]a, indicated with red square]. Proton MR spectroscopy at 3.0 T showed a decrease in N-acetylaspartate (neuronal marker) [[Figure 1]b, arrow] and an increase in choline [[Figure 1]b, double arrows]. Surgical intervention revealed a low-grade glioma. Nocturnal seizure represents a significant diagnostic challenge for clinicians. Chest pain may occur after tonic-clonic seizures. [1] Therefore, elevated serum CK is helpful for diagnosing generalized seizures. [2]
Figure 1: (a) Magnetic resonance imaging of the brain revealed abnormal hyperintensity area in the right mesial temporal lobe. (b) Proton MR spectroscopy showed a decrease in N-acetylaspartate (neuronal marker) (arrow) and an increase in choline (double arrows)

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1.Lee TH, Goldman L. Evaluation of the patient with acute chest pain. N Engl J Med 2000;342:1187-95.  Back to cited text no. 1
    
2.Libman MD, Potvin L, Coupal L, Grover SA. Seizure vs. syncope: Measuring serum creatine kinase in the emergency department. J Gen Intern Med 1991;6:408-12.  Back to cited text no. 2
    


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