Seizure vs. syncope

Objective:To determine the utility of serum creatine kinase measurement for diagnosing generalized tonic-clonic seizures in patients presenting to an emergency department with transient loss of consciousness. Design:Prospective evaluation of a diagnostic parameter. Retrospective data collection with blinded assignment to diagnostic groups. Setting:University teaching hospital. Patients:Sequential sample of 205 patients with transient loss of consciousness. The study group consisted of 96 patients who had creatine kinase measurements in the emergency department. Measurements and main results:An investigator blinded to the results of creatine kinase measurements retrospectively classified events into seizure and nonseizure groups on the basis of clinical presentation, prior history, and follow-up investigations. Mean (±SE) creatine kinase level was significantly higher in the seizure group (231.1±34.8 U/L vs. 70.5±5.6 U/L, p