Gibt es Änderungen des Metaboloms in Urin oder Serum nach Fieberkrämpfen und anderen epileptischen Anfällen im Kindes- und Jugendalter?

Metabolomic analysis using mass spectrometry and proteomics enables the identification of potential biomarkers of epileptic seizures. This study aimed to detect biochemical markers in urine and plasma to support non-invasive diagnostics and monitoring, while also assessing the influence of nutrition and fluid intake on the metabolome.

One to three urine samples at different time points and postictal plasma samples were collected from pediatric participants with diagnosed epilepsy. Proteomic analysis was performed using bottom-up MS-based proteomics. As a control, the same children were re-sampled 24 hours postictally. Structured questionnaires on daily routine, nutrition, and hydration were also included.

Several metabolites were found to be altered immediately after seizures and may represent modifiable variables influencing seizure occurrence. Notably, an increase of glutamine, lactate, urate, and ornithine was observed, accompanied by a reduction of L-histidine, creatine, L-carnitine, and the branched-chain amino acids valine, leucine, and isoleucine, suggesting an acute disturbance of central metabolic pathways.

These metabolites may serve as a basis for novel diagnostic tests or as biomarkers for monitoring disease progression and treatment adaptation. The results further provide insights that may contribute to the development of therapeutic approaches by improving understanding of the pathophysiology of childhood epilepsy.

This study highlights the importance of biomarker research in refining diagnosis and therapy of epileptic seizures. Future work should validate the identified markers and assess their clinical applicability.

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