Lactic Acidosis During and After Seizures

Study Overview
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Brief Summary
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This project looks at the time course of lactic acid rise (if any) after seizures. Salivary and capillary lactic acid are tested. This type of measurement may be useful in signalling the occurrence or recent history of a seizure.

Detailed Description
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Lactic acid is released from cells during seizures and elevates lactic acid levels in blood and saliva. The time course of this rise is unknown. If lactic acid rises within a few minutes of a seizure, than it might be feasible to develop lactic acid sensors to provide notification of a recent seizure. This could lead to better safety monitoring for people with epilepsy. This study was designed to utilize a commercially available lactic acid sensor (investigators have no connection with the sensor manufacturer and purchased the device at list price) to measure salivary lactic acid levels after a seizure during inpatient video-EEG epilepsy monitoring.

Official Title
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Lactic Acidosis During and After Seizures

Conditions
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Epilepsy

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18-75 inclusive. History of at least one generalized tonic-clonic (grand mal) seizure prior to enrollment in the study. Undergoing monitoring in the Stanford Epilepsy Monitoring Unit. Exclusion Criteria: Not pregnant. Inability to understand and sign the consent form. No known history of mitochondrial disease or other metabolic disorders expected to affect blood lactate. No known history of thrombophlebitis or excessive tendency to bleeding. Not on coumadin. Aspirin or anti-platelet agents are not an exclusion. No known peripheral vascular disease affecting blood circulation to the fingers. No painful peripheral neuropathy. No Raynaud's disease or phenomenon.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 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 inpatients<br>Patients with epilepsy recorded in an inpatient video-EEG monitoring unit after a seizure. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Salivary Lactic Acid Levels With Seizures | The investigators will assess the salivary lactic acid within 10 minutes after end of a seizure. Values will consist of lactic acid measurements in saliva , immediately post-seizure. Units of measurement will be mM/L. A positive outcome will be a curve different from a straight line, with a rise and fall of lactate levels. Baseline lactate serum level is expected to be less than 2.2 mM/L. | Within 10 minutes of end of the seizure | 
| Capillary Lactic Acid Levels With Seizures | The investigators will assess the capillary lactic acid within 10 minutes after end of a seizure. Values will consist of lactic acid measurements in blood, within 10 minutes after the end of a seizure. Units of measurement will be mM/L. Baseline lactate serum level is expected to be less than 2.2 mM/L. | Within 10 minutes of end of the seizure | 
| Intravenous Lactic Acid Levels With Seizures | The investigators will assess the intravenous lactic acid within 10 minutes after end of a seizure. Values will consist of lactic acid measurements in serum collected by IV, immediately post-seizure. Units of measurement will be mM/L. A positive outcome will be a curve different from a straight line, with a rise and fall of lactate levels. Baseline lactate serum level is expected to be less than 2.2 mM/L. | Within 10 minutes of end of the seizure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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epilepsy, lactic acid, saliva, postictal