The role of oxidative and antioxidative status in patients with suspected seizures in the emergency department

Aim: The aim of this study was to investigate the diagnostic value of Total oxidant level (TOS) and Total antioxidant level (TAS) in the differentiation of epileptic seizures and psychogenic nonepileptic seizures (PNES) in adult patients presenting to the emergency department (ED) with complaints of seizures. Material and Method: This prospective observational study was conducted at Antalya Training and Research Hospital. Patients were categorized into either a pseudoseizure group or a seizure group. Serum TAS and TOS levels were measured spectrophotometrically by colorimetric methods. Thirty and 60 minutes after the onset of symptoms, serum samples were collected for measuring serum albumin, ischemia modified albumin (IMA), TAS and TOS levels. Data were analyzed using SPSS 21. Results: A total of 110 participants were categorized into either a pseudoseizure group (n=48, 43.6%) or a seizure group (n=62,56.4%). Regarding 30-minute IMA and TOS, levels were significantly higher in the seizure group (p=0.001 and p<0.001). There was no statistically significant difference between seizure and pseudoseizure groups in terms of 30-minute TAS levels (p=0.16). Regarding 60-minute, IMA and TOS, levels were significantly higher in the seizure group (p<0.001 and p=0.002, p<0.05). There was no statistically significant difference between seizure and pseudoseizure groups in terms of TAS levels (p=0.19). Anion gap and lactate levels were significantly higher in the seizure group (p<0.001). Discussion: According to the results of our study, serum IMA, anion gap, lactate, and TOS levels increased significantly in patients with seizures compared to patients with pseudoseizures.