Background: Motor signs accompanying seizures have been considered to result in over-exertion of muscles and have the ability to cause elevated levels of serum creatine kinase (CK). There were no previous studies on the treatment of seizure-induced elevated CK. We summarized the characteristics and treatments of six patients with significant elevation of CK after seizure onset.

Case report: There were four males and two females, the age range was 16 to 68 years. The CK levels were greater than 5,000 U/L in five of the six patients and the highest CK level was 39,300 U/L. All patients exhibited an estimated glomerular filtration rate (eGFR) < 90 ml/min/1.73m². No patient developed renal failure or required continuous renal replacement therapy. We determined that serial assessment of CK, myoglobin, eGFR, and electrolytes should be performed in patients following seizures. Furthermore, fluid resuscitation, urine alkalization, and diuretic agents should be administrated when CK are significantly elevated after seizure onset.

Conclusions: Serial assessment of CK levels after seizures should be performed, especially when the patient experiences electrolyte disorders. Fluid resuscitation, urine alkalization, and diuretic agents also should be administrated to patients when they exhibit a significantly elevated CK or myoglobin after seizures.

Keywords: Creatine kinase, Seizures, HyperCKemia, Acute kidney injury, Treatment