Abstract Details

Title Screening of Takotsubo Syndrome (TKS) after Seizure by Troponin Assay: A Prospective Study

Topic Epilepsy

Presentation(s) P03 - (-)

Poster/Presentation
Number 131

Objective

Background BACKGROUND: There is an increased risk of premature mortality in patients with epilepsy. TKS is a recently described acute cardiac insufficiency which manifests after stress as an acute myocardial infarction and is characterized by ST segment elevation on the electrocardiogram, elevation of the markers of heart disease, cardiac ultrasound abnormalities and absence of coronary lesions. It can induce cardiac decompensation, embolism, arrhythmia and death. The actual incidence of TKS is estimated to 1/36000. More than 50 cases of TKS after seizure have been published (Dupuis- Seizure 2012).

Design/Methods DESIGN/METHODS: Between November 2009 and July 2012, prospectively, all adult patients (>18 years) admitted in 2 hospitals after seizure had a troponin dosage within 2-4h. Informed consent were submitted to potential applicants of the study. Measurements of troponin were considered abnormal if superior to respective cut-off of the 2 hospitals: 0.08 or 0.3ng/ml. Patients with high troponin levels were treated following medical guidelines. Results were collected anonymously.

Results RESULTS: Data from 690 patients were collected. 144 showed elevated troponin (20.8%). From these, 36% had troponin elevation due to seizures, 5 patients (=0.72 % with 95 % CI: 0.52-0.92 %) were given a diagnostic of TKS; their median age was 63 years old and they all fully recovered. Considering the estimated incidence of TKS in the general population (1/36000), the pathology is 250 times more frequent than in the general population.

Conclusions CONCLUSIONS: Screening of TKS after seizures by troponin is feasible and the occurrence is not exceptional, with implications for the cardiologic treatment of these patients. This is the second prospective study and the largest. TKS after seizure is a neglected topic, and the implication of TKS in SUDEP (Sudden Unexpected Death in Epilepsy) should also be considered.

Authors/Disclosures
Nicolas Dubuisson PRESENTER	No disclosure on file
Teena Shetty, MD, FAAN (Hospital for Special Surgery)	Dr. Shetty has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for mTBI, Inc. The institution of Dr. Shetty has received research support from Marker AG. The institution of Dr. Shetty has received research support from GE-NFL.
Michel Dupuis, MD	Dr. Dupuis has nothing to disclose.
Frederic Evrard	No disclosure on file
	No disclosure on file
Fabien Dupuis (Universite Catholique de Louvain)	No disclosure on file
K Van Rijckevorsel, MD	No disclosure on file

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