Related Experiment Video
Updated: Dec 12, 2025
10:46
Author Spotlight: Obtaining High-Quality CSF and Blood Samples for Epilepsy Biomarker Discovery
Published on: September 1, 2023
4.1K
Testing blood and CSF in people with epilepsy: a practical guide
Fiona Sutton1, Diana Barca2, Ilia Komoltsev3
1Institute of Medical & Biomedical Education, St George's University of London, UK.
Summary
Laboratory tests are crucial for diagnosing the cause and guiding treatment of seizures and epilepsy. Prompt identification of acute causes like metabolic or toxic issues, and monitoring antiepileptic drugs (AEDs), can prevent severe outcomes.
Area of Science:
- Neurology
- Clinical Chemistry
Background:
- Laboratory investigations are not essential for diagnosing seizures or epilepsy but are vital for determining underlying causes and guiding patient management.
- Over 50% of first-time seizures have acute symptomatic origins, including metabolic, toxic, or infectious factors, which can also trigger status epilepticus.
- Failure to identify seizures linked to substance misuse may result in incorrect antiepileptic drug (AED) treatment and missed opportunities for effective intervention.
Purpose of the Study:
- To review the indications for laboratory testing (blood, urine, cerebrospinal fluid) in patients with new-onset seizures, status epilepticus, and established epilepsy.
- To highlight the importance of laboratory monitoring for managing epilepsy, including identifying acute causes, monitoring AEDs, and assessing bone health.
- To mention rare neurometabolic and genetic disorders associated with epilepsy.
Main Methods:
- Review of indications for blood, urine, and cerebrospinal fluid tests.
- Discussion of laboratory monitoring in specific patient populations (e.g., extremes of age, pregnancy, renal/hepatic dysfunction).
- Consideration of acute symptomatic causes and antiepileptic drug (AED) management.
Main Results:
- Laboratory tests are fundamental in identifying acute symptomatic causes of seizures (metabolic, toxic, infectious) and guiding management.
- Prompt diagnosis of conditions like hypoglycemia or hyponatremia is critical to prevent fatal outcomes.
- Monitoring is recommended for established epilepsy patients, particularly concerning bone health and during physiological changes affecting AED metabolism.
Conclusions:
- Laboratory investigations play a fundamental role in the etiological diagnosis and management of seizures and epilepsy.
- Awareness of common laboratory derangements associated with individual AEDs is essential for clinicians.
- Testing guides the management of new-onset seizures, status epilepticus, and ongoing care for individuals with established epilepsy.
