Background
Elevated serum creatine kinase (CK) could indicate muscle cell damage due to muscle trauma, strenuous exercise, or the use of certain drugs [1-3]. Numerous cytoplasmic components within muscle cells exit through the damaged sarcolemma, including myoglobin and electrolytes, which are involved in acute kidney injury (AKI) and possible cardiac dysrhythmia [1, 4, 5].
Motor signs associated with seizures, including tonic, clonic, and myoclonic movements, can be considered muscle overuse [1, 6]. Seizures can induce elevated CK levels, which might serve as a marker to distinguish epileptic seizures from non-epileptic seizures [7-10]. Seizures have been identified as the cause of 4.0% of the cases of rhabdomyolysis (RM) and 6.1% of the exertional RM cases [11, 12]. One study demonstrated that renal replacement therapy or in-hospital mortality due to seizures accounted for 6.0% of patients with CK > 5,000 U/L [13]. Elevated CK levels induced by seizures have been observed in clinical practice, but the occurrence has not received much attention, and there are few published reports on this topic. Given that CK levels can be elevated when seizures occur, this could lead to severe complications. Therefore, appropriate treatment should be provided that might improve the prognosis of patients with seizure onset.
However, rare cases of significantly elevated CK caused by seizures were reported in clinical practice, and there were no previous studies on the treatment of seizures induced elevated CK. In this study, we summarized the characteristics and treatments of six patients with significantly elevated CK levels induced by seizures. We anticipated that the results reported here would encourage more attention to this infrequent complication associated with seizures.