Kinetics of serum neuron-specific enolase and prolactin in patients after single epileptic seizures.
OBJECTIVE
To investigate and compare the temporal profile of serial levels of neuron-specific enolase (NSE) and prolactin in serum from patients after single epileptic seizures.


METHODS
Measurement of NSE and prolactin by sensitive immunoassays in 21 patients with complex partial seizure (CPSs: n = 11) and secondarily generalized tonic-clonic seizures (SGTCSs; n = 10) during continuous video-EEG monitoring at four different time points (1, 3, 6, and 24 h after ictal event). Statistical analysis was performed by using a repeated-measures analysis of variance (ANOVA) model.


RESULTS
Mean+/-SD values for NSE levels (ng/ml) were 12.5 +/-4.4 (1 h), 10.8+/-3.8 (3 h), 11.1+/-4.9 (6 h), and 8.2+/-1.9 (24 h). The corresponding prolactin levels (mU/L) were 1,311+/-1,034, 232+/-158, 237+/-175, and 251+/-98. There was a significant decrease of NSE and prolactin levels over time (p < 0.001). The pair-wise comparison of NSE levels showed significant differences between the time points 1 vs. 24 h (p < 0.001), 3 vs. 24 h (p = 0.007), and 6 vs. 24 h (p = 0.009). In contrast, serum prolactin levels showed a significant difference between 1 vs. 3 h (p < 0.001) only. Most of the NSE levels remained normal after CPSs and SGTCSs. At 1 h after the seizure, only 33% of the subjects had increased NSE, whereas abnormal prolactin levels occurred with a sensitivity of 80%.


CONCLUSIONS
In contrast to prolactin, serum NSE is not a sensitive marker of individual seizures. Only some individuals showed an increase of NSE beyond the prolactin-sensitive time frame after a single seizure, and mean NSE levels were not significantly increased compared with those of normal controls.
Tumani
H
H
Department of Neurology, University of Göttingen, Germany.
Otto
M
M
Gefeller
O
O
Wiltfang
J
J
Herrendorf
G
G
Mogge
S
S
Steinhoff
B J
BJ
D000328:Adult; D000704:Analysis of Variance; D015415:Biomarkers; D001812:Blood-Brain Barrier / Q000502:physiology; D001921:Brain / Q000201:enzymology / Q000378:metabolism* / Q000503:physiopathology; D003937:Diagnosis, Differential; D004569:Electroencephalography / Q000706:statistics & numerical data; D004828:Epilepsies, Partial / Q000097:blood / Q000175:diagnosis / Q000201:enzymology; D004827:Epilepsy / Q000097:blood* / Q000175:diagnosis / Q000201:enzymology*; D005260:Female; D006801:Humans; D007118:Immunoassay; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D011388:Prolactin / Q000097:blood*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014743:Videotape Recording
D015415:Biomarkers; D011388:Prolactin; D010751:Phosphopyruvate Hydratase