Copeptin in Childhood Epilepsy

Study Overview
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Brief Summary
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In many fields of medicine, except seizure disorders, blood biomarkers have captured an integrated part of diagnostic decision making, including copeptin, the surrogate marker of vasopressin release. There are strong arguments to hypothesize circulating copeptin is elevated in epilepsy, especially in generalized seizures such as fever seizures (FS), and that copeptin is predictive for complexity and relapse at least in FS. Although long-term morbidity and mortality are both low in FS, there is high anxiety among parents because of a lack of criterions to identify children at risk for relapse. Copeptin may fill this gap by adding important diagnostic and prognostic information. Eventually, less children may receive needlessly over years fever drugs or anti-epileptic drugs.

Detailed Description
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Background: Copeptin is a surrogate marker of the pituitary-secreted nonapeptide arginine-vasopressin (AVP) and has gradually replaced AVP in several clinical studies largely due to its structural and methodological advantages. Copeptin is a marker of non-specific stress response, and has been suggested to have clinical implications in a variety of cardiovascular and non-cardiovascular conditions. However, up to now there are no data available on copeptin in seizure disorders, neither in adults nor in children. Working hypotheses: Circulating copeptin concentrations are increased after generalized seizures, including FS. Copeptin is predictive for complexity and relapse in FS. Specific aims: to determine copeptin concentrations in children below six years after generalized seizures, either unrelated or related to fever (FS), and in control children below six years without seizures. to compare copeptin concentrations with blood-gas parameters (including hydrogen ion concentration (pH), base deficiency, and carbon dioxide), lactate, sodium, chloride, C reactive protein (CRP), and prolactin.

Official Title
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Prospective Study on Copeptin in Childhood Epilepsy

Conditions
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Epilepsy, Febrile Seizures, Children

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria epilepsy-cohort: All kind of seizures leading to presentation Age below 6 years Inclusion Criteria control-cohort: Fever without seizures caused by banal infections Age below 6 years Exclusion Criteria: No blood required for medical reasons

Ages Eligible for Study
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Maximum Age: 5 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Epilepsy<br>All kind of epilepsy, including febrile seizures | |
| Control<br>children without seizures at presentation in the emergency but fever due to banal infections | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Copeptin concentration in serum |  | at admission | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| base excess in blood gas analysis |  | at admission | 
| prolactin |  | at admission | 
| duration of seizures |  | at admission | 
| Short term relapse of seizures |  | 24 hours after first presentation | 
| sodium concentration |  | at admission | 
| osmolality |  | at admission | 
| hydrogen ion activity in blood gas analysis | hydrogen ion activity = pH | at admission |