Download PDF
Journal of Pediatric Epilepsy 2016; 05(01): 018-025
DOI: 10.1055/s-0035-1570337
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Study of Brain-Type Natriuretic Peptide in Children with Epileptic Seizures

Hamdi M. Bediar
1   Department of Pediatrics, Alexandria University, Alexandria, Egypt
,
Hanan G. Azouz
1   Department of Pediatrics, Alexandria University, Alexandria, Egypt
,
Magdi M. El-Bordeni
2   Department of Clinical and Chemical Pathology, Alexandria University, Alexandria, Egypt
,
Elham E. Elsakka
1   Department of Pediatrics, Alexandria University, Alexandria, Egypt
,
Mohamed A. Nour El-Din
1   Department of Pediatrics, Alexandria University, Alexandria, Egypt
› Author Affiliations
Further Information

Publication History

25 May 2014

16 March 2015

Publication Date:
11 January 2016 (online)

    Permissions and Reprints

Abstract

Background Elevated N-terminal of the prohormone brain natriuretic peptide (NT-proBNP) concentrations in childhood epilepsy and febrile convulsions has been reported. The present study was conducted on 30 children at Alexandria University Children's Hospital. They have been classified into two groups: (1) seizures group which included 20 postictal children (10 males and 10 females), subdivided into 10 children with partial epilepsy who had partial motor seizures (PS) and 10 children with idiopathic generalized epilepsy who had tonic–clonic seizures and (2) control group which included 10 children (8 males and 2 females) who was randomly selected from epileptic children after a seizure-free period of at least for 2 months. All cases and controls were subjected to full history taking, clinical examination with emphasis on neurological examination, and routine laboratory investigations to exclude any disease that may alter serum level of BNP, such as cardiac, renal, or hepatic disease. For seizures group, plasma concentration (NT-proBNP) was measured within 4 hours after seizure onset and again 24 to 48 hours later. For control group NT-proBNP was measured once. Subanalyses were done and plasma NT-proBNP levels in each subgroup of postseizure group within 4 hours postictal were compared with NT-proBNP levels among control group.

Results NT-proBNP plasma concentrations within 4 hours postictal were significantly higher among the postseizure group compared with the control group. Significant decrease of NT-proBNP levels in the postseizure group was observed after the 24- to 48-hour follow-up. NT-proBNP plasma concentrations were significantly higher among patients with generalized seizures compared with controls.

Conclusion Plasma NT-proBNP assay when measured in the appropriate clinical setting may be useful in the diagnosis of childhood epilepsy.

Keywords

brain type natriuretic peptide - epilepsy - NT-proBNP - generalized seizures - partial seizures
 

  • References

  • 1 Guidelines for epidemiologic studies on epilepsy. Commission on Epidemiology and Prognosis, International League Against Epilepsy. Epilepsia 1993; 34 (4) 592-596
    CrossrefPubMedGoogle Scholar
  • 2 Blume WT, Lüders HO, Mizrahi E, Tassinari C, van Emde Boas W, Engel Jr J. Glossary of descriptive terminology for ictal semiology: report of the ILAE task force on classification and terminology. Epilepsia 2001; 42 (9) 1212-1218
    CrossrefPubMedGoogle Scholar
  • 3 ILAE Commission Report. The epidemiology of the epilepsies: future directions. International League Against Epilepsy. Epilepsia 1997; 38 (5) 614-618
    CrossrefPubMedGoogle Scholar
  • 4 Hauser WA, Annegers JF, Kurland LT. Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota: 1935-1984. Epilepsia 1993; 34 (3) 453-468
    CrossrefPubMedGoogle Scholar
  • 5 Proposal for revised clinical and electroencephalographic classification of epileptic seizures. From the Commission on Classification and Terminology of the International League Against Epilepsy. Epilepsia 1981; 22: 489-501
    CrossrefPubMedGoogle Scholar
  • 6 Karachristianou S, Bostantjopoulou S, Katsarou Z, Kazis A. Neuropsychological EEG activation in patients with juvenile myoclonic epilepsy. Funct Neurol 2004; 19 (3) 185-189
    PubMedGoogle Scholar
  • 7 Cascino GD. Use of routine and video electroencephalography. Neurol Clin 2001; 19 (2) 271-287
    CrossrefPubMedGoogle Scholar
  • 8 Chen DK, So YT, Fisher RS ; Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Use of serum prolactin in diagnosing epileptic seizures: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2005; 65 (5) 668-675
    CrossrefPubMedGoogle Scholar
  • 9 de Bold AJ, Borenstein HB, Veress AT, Sonnenberg H. A rapid and potent natriuretic response to intravenous injection of atrial myocardial extract in rats. Life Sci 1981; 28 (1) 89-94
    CrossrefPubMedGoogle Scholar
  • 10 Betts T. Pseudoseizures: seizures that are not epilepsy. Lancet 1990; 336 (8708) 163-164
    CrossrefPubMedGoogle Scholar
  • 11 Redfield MM, Aarhus LL, Wright RS, Burnett Jr JC. Cardiorenal and neurohumoral function in a canine model of early left ventricular dysfunction. Circulation 1993; 87 (6) 2016-2022
    CrossrefPubMedGoogle Scholar
  • 12 Sudoh T, Kangawa K, Minamino N, Matsuo H. A new natriuretic peptide in porcine brain. Nature 1988; 332 (6159) 78-81
    CrossrefPubMedGoogle Scholar
  • 13 Yasue H, Yoshimura M, Sumida H , et al. Localization and mechanism of secretion of B-type natriuretic peptide in comparison with those of A-type natriuretic peptide in normal subjects and patients with heart failure. Circulation 1994; 90 (1) 195-203
    CrossrefPubMedGoogle Scholar
  • 14 Marin-Grez M, Fleming JT, Steinhausen M. Atrial natriuretic peptide causes pre-glomerular vasodilatation and post-glomerular vasoconstriction in rat kidney. Nature 1986; 324 (6096) 473-476
    CrossrefPubMedGoogle Scholar
  • 15 Edwards BS, Zimmerman RS, Schwab TR, Heublein DM, Burnett Jr JC. Atrial stretch, not pressure, is the principal determinant controlling the acute release of atrial natriuretic factor. Circ Res 1988; 62 (2) 191-195
    CrossrefPubMedGoogle Scholar
  • 16 Liang F, O'Rear J, Schellenberger U , et al. Evidence for functional heterogeneity of circulating B-type natriuretic peptide. J Am Coll Cardiol 2007; 49 (10) 1071-1078
    CrossrefPubMedGoogle Scholar
  • 17 Rauchenzauner M, Haberlandt E, Rösslhuber C , et al. Cerebrospinal fluid and serum NT-proBNP concentrations in children with epilepsy. Epilepsy Res 2009; 86 (2–3) 131-137
    CrossrefPubMedGoogle Scholar
  • 18 Rauchenzauner M, Haberlandt E, Högler W, Luef G. Brain-type natriuretic peptide release and seizure activity during vagal nerve stimulation. Epilepsia 2007; 48 (2) 397-399
    CrossrefPubMedGoogle Scholar
  • 19 Rauchenzauner M, Haberlandt E, Foerster S , et al. Brain-type natriuretic peptide secretion following febrile and afebrile seizures - a new marker in childhood epilepsy?. Epilepsia 2007; 48 (1) 101-106
    PubMedGoogle Scholar
  • 20 Proposal for revised classification of epilepsies and epileptic syndromes. Commission on Classification and Terminology of the International League Against Epilepsy. Epilepsia 1989; 30 (4) 389-399
    CrossrefPubMedGoogle Scholar
  • 21 Yang RH, Jin HK, Wyss JM, Chen YF, Oparil S. Pressor effect of blocking atrial natriuretic peptide in nucleus tractus solitarii. Hypertension 1992; 19 (2) 198-205
    CrossrefPubMedGoogle Scholar
  • 22 Jansen K, Lagae L. Cardiac changes in epilepsy. Seizure 2010; 19 (8) 455-460
    CrossrefPubMedGoogle Scholar
  • 23 Pack AM, Olarte LS, Morrell MJ, Flaster E, Resor SR, Shane E. Bone mineral density in an outpatient population receiving enzyme-inducing antiepileptic drugs. Epilepsy Behav 2003; 4 (2) 169-174
    CrossrefPubMedGoogle Scholar
  • 24 Fitzpatrick LA. Pathophysiology of bone loss in patients receiving anticonvulsant therapy. Epilepsy Behav 2004; 5 (2) (Suppl. 02) S3-S15
    PubMedGoogle Scholar
  • 25 Shima M, Seino Y, Torikai S, Imai M. Intrarenal localization of degradation of atrial natriuretic peptide in isolated glomeruli and cortical nephron segments. Life Sci 1988; 43 (4) 357-363
    CrossrefPubMedGoogle Scholar
  • 26 Albers S, Mir TS, Haddad M, Läer S. N-Terminal pro-brain natriuretic peptide: normal ranges in the pediatric population including method comparison and interlaboratory variability. Clin Chem Lab Med 2006; 44 (1) 80-85
    PubMedGoogle Scholar
  • 27 Oremus M, Raina P, Santaguida P. A systematic review of BNP and NT-proBNP as predictors of prognosis in persons with coronary artery disease. Clin Biochem 2007; 10: 1016
    PubMedGoogle Scholar
  • 28 Wang TJ, Larson MG, Levy D , et al. Plasma natriuretic peptide levels and the risk of cardiovascular events and death. N Engl J Med 2004; 350 (7) 655-663
    CrossrefPubMedGoogle Scholar
  • 29 Berendes E, Walter M, Cullen P , et al. Secretion of brain natriuretic peptide in patients with aneurysmal subarachnoid haemorrhage. Lancet 1997; 349 (9047) 245-249
    CrossrefPubMedGoogle Scholar
  • 30 Lathers CM, Schraeder PL. Autonomic dysfunction, cardiac arrhythmias and epileptogenic activity. In: Lathers CM, Schraeder PL, eds. Epilepsy and Sudden Death. New York: Marcel Dekker; 1990: 135
    Google Scholar
  • 31 Chin PS, Branch KR, Becker KJ. Myocardial infarction following brief convulsive seizures. Neurology 2004; 63 (12) 2453-2454
    CrossrefPubMedGoogle Scholar
  • 32 Sabatine MS, Morrow DA, de Lemos JA , et al. Acute changes in circulating natriuretic peptide levels in relation to myocardial ischemia. J Am Coll Cardiol 2004; 44 (10) 1988-1995
    CrossrefPubMedGoogle Scholar
  • 33 Alehan F, Erol I, Cemil T, Bayraktar N, Ogüs E, Tokel K. Elevated CK-MB mass and plasma brain-type natriuretic peptide concentrations following convulsive seizures in children and adolescents: possible evidence of subtle cardiac dysfunction. Epilepsia 2009; 50 (4) 755-760
    CrossrefPubMedGoogle Scholar
  • 34 Mäkikallio AM, Mäkikallio TH, Korpelainen JT , et al. Natriuretic peptides and mortality after stroke. Stroke 2005; 36 (5) 1016-1020
    CrossrefPubMedGoogle Scholar
  • 35 Perrone BL, Vari RC, Kreisman NR. Recurrent seizures alter renal function and plasma atrial natriuretic peptide levels in rats. Epilepsia 1995; 36 (7) 649-657
    CrossrefPubMedGoogle Scholar