From the Guidelines
Lactic acid testing is not a recommended diagnostic tool for seizures, and its use should be limited to evaluating other conditions that may present with seizure-like episodes. The evaluation and management of adult patients presenting with seizures should follow established guidelines, such as those outlined in the Annals of Emergency Medicine 1. When evaluating patients with a first-time seizure, the focus should be on determining the underlying cause, with recommended tests including serum glucose and sodium levels for patients with no comorbidities who have returned to their baseline 1.
Some key points to consider when evaluating seizures include:
- Determining a serum glucose and sodium level on patients with a first-time seizure with no comorbidities who have returned to their baseline 1
- Obtaining a pregnancy test if a woman is of childbearing age 1
- Performing a lumbar puncture, after a head computed tomography (CT) scan, either in the ED or after admission, on patients who are immunocompromised 1 However, lactic acid testing is not specifically recommended for diagnosing seizures.
The primary diagnostic tools for seizures include electroencephalogram (EEG), brain imaging (MRI or CT scan), and clinical evaluation of symptoms. If lactic acid testing is performed, it should be done promptly after a suspected seizure event, but the results alone cannot confirm or rule out seizures. For proper seizure diagnosis, patients should be referred to a neurologist who can perform comprehensive testing including EEG monitoring, which remains the gold standard for seizure diagnosis 1.
From the Research
Lactic Acid and Seizures
- There is no direct evidence in the provided studies that links lactic acid to testing for seizures 2, 3, 4, 5, 6.
- The studies focus on the treatment and management of seizures and epilepsy, including the use of antiepileptic drugs and their efficacy in controlling different types of seizures 2, 3, 5.
- Some studies discuss the diagnosis and evaluation of seizures, including the use of electroencephalography and brain imaging, but do not mention lactic acid as a diagnostic tool 4, 6.
- The management of seizures and epilepsy involves a comprehensive approach, including accurate diagnosis, medication, and lifestyle modifications, but lactic acid is not mentioned as a relevant factor in this context 2, 3, 4, 5, 6.