Serum GLM4 and GABRA6 levels for differentiating seizures from mimics: An observational case–control study

Objectives: The objectives of the study are to assess and contrast the serum concentrations of GLM4 and GABRA6 in patients diagnosed with seizures versus those with seizure mimics. Material and Methods: In an observational case–control design, at the Great Eastern Medical School and Hospital between January 2021 and March 2023, we studied 85 individuals with seizures (cases) and 89 individuals without seizures (controls), who had a seizure mimic, such as syncope or a psychogenic non-epileptic seizure. The age range of the participants was between 18 and 60 years. Quantification of blood GLM4 and GABRA6 levels using the enzyme-linked immunosorbent assay method was one of the primary outcome measures. Results: People with seizures had a significantly higher average GLM4 level than people without seizures (3.47 vs. 1.3 ng/mL, p < 0.001). In cases, GABRA6 levels were substantially higher than in controls (3.71 vs. 1.01 ng/mL, p < 0.001). With a suitable cutoff value of 3.5 ng/mL, the GLM4 analysis produced an 81% specificity and a 71% sensitivity. For GABRA6 , a cutoff value of 4 ng/mL resulted in 89% specificity and 63% sensitivity. Conclusion: Patients with verified seizures exhibited notably increased levels of serum GLM4 and GABRA6 , in contrast to individuals with seizure mimics. These markers exhibit potential in distinguishing between seizures and imitations in cases when the diagnosis is uncertain.