Normal CSF neuron-specific enolase and S-100 protein levels in patients with recent non-complicated tonic-clonic seizures.
OBJECTIVE
Increased concentrations of the nervous-system-specific proteins neuron-specific enolase (NSE) and S-100 protein (S-100) have been measured with lesions in the CNS. Elevated levels of serum NSE (s-NSE) have been found in status epilepticus, but also after single epileptic seizures. Because larger studies addressing cerebrospinal fluid (CSF) levels of NSE or S-100 have not been performed, we measured CSF NSE and S-100 after tonic-clonic seizures to search for evidence of neuronal and glial damage.


METHODS
22 consecutive patients with single, previously undiagnosed and untreated tonic-clonic seizures were studied. Serum and CSF samples were collected within 24 h after seizure. 18 serum and CSF samples were measured from a control group.


RESULTS
The mean CSF NSE was 8.9 ng/ml (range 0-28 ng/ml) and s-NSE 8.2 ng/ml (range 5-15 ng/ml) in the patient group. The mean concentrations in the control group were 13.1 ng/ml (range 3-24 ng/ml) and 8.0 ng/ml (range 5-12 ng/ml) respectively. The mean CSF S-100 was 3.17 microg/l (range 1.45-7.02 microg/l) and serum S-100 0.05 microg/l (range 0-0.32 microg/l), and in controls 3.19 microg/l (range 1.52-5.13 microg/l) and 0.08 microg/l (range 0-0.28 microg/l).


CONCLUSIONS
There were no significant differences between the mean concentrations of NSE or S-100 in CSF and serum between the epileptic group and controls. These results do not confirm the previous observation of elevated NSE-levels after tonic-clonic seizures, which argues against neuronal or glial damage after uncomplicated tonic-clonic seizures in unmedicated patients.
Palmio
J
J
Department of Neurology, Tampere University Hospital, P.O. Box 2000, Fin-33521, Tampere, Finland. johanna.palmio@nic.fi
Peltola
J
J
Vuorinen
P
P
Laine
S
S
Suhonen
J
J
Keränen
T
T
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D006801:Humans; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000097:blood / Q000134:cerebrospinal fluid*; D009418:S100 Proteins / Q000097:blood / Q000134:cerebrospinal fluid*; D012640:Seizures / Q000097:blood / Q000134:cerebrospinal fluid*
D009418:S100 Proteins; D010751:Phosphopyruvate Hydratase