title: Serum and cerebrospinal fluid S100B, neuron-specific enolase, and total tau protein in acute encephalopathy with biphasic seizures and late reduced diffusion: a diagnostic validity.
abstract: BACKGROUND
  Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is characterized clinically by biphasic seizures and late magnetic resonance imaging abnormalities, such as reduced subcortical diffusion from day 3 onwards, often accompanied with some neurological sequelae. In the early stages of the disease, AESD closely resembles its far more prevalent and relatively benign counterpart, febrile seizure (FS).
  
  
  METHODS
  We measured and compared the serum or cerebrospinal fluid (CSF) levels of S100B, neuron-specific enolase (NSE), and total tau protein in 43 patients with FS and 18 patients with AESD, at any point during the disease. To assess early diagnostic validity, we compared these biomarkers in 43 FS and eight AESD patients, with whom the day 0-2 samples were available. We used the receiver-operator characteristic curve to evaluate the diagnostic values of these markers.
  
  
  RESULTS
  The levels of all biomarkers were significantly higher in AESD than FS patients. When only day 0-2 samples from AESD patients were used, the levels of all the measured biomarkers, except serum NSE, were still significantly higher in patients with AESD than in FS, suggesting that AESD could damage astrocytes, neurons, and axons, even in the early stages of the disease. According to the receiver-operator characteristic curve analyses, CSF S100B (cut-off value, 100 pg/mL) and CSF total tau protein (cut-off value, 100 pg/mL) were better predictors of AESD than other biomarkers.
  
  
  CONCLUSIONS
  The combination of CSF S100B and CSF total tau protein resulted in a positive predictive value of AESD 83.3%, which could be helpful for early diagnosis, facilitating early therapeutic interventions.
authors: Department of Neurology, Gunma Children's Medical Center, Shibukawa, Gunma 377-8577, Japan. shiihara-ind@umin.net
authors: Takashi
authors: T
authors: Shiihara
authors: Taeko
authors: T
authors: Miyake
authors: Sakiko
authors: S
authors: Izumi
authors: Mio
authors: M
authors: Watanabe
authors: Keiko
authors: K
authors: Kamayachi
authors: Kazuhiko
authors: K
authors: Kodama
authors: Makoto
authors: M
authors: Nabetani
authors: Masako
authors: M
authors: Ikemiyagi
authors: Yoshio
authors: Y
authors: Yamaguchi
authors: Noriko
authors: N
authors: Sawaura
mesh_terms: D015415:Biomarkers / Q000097:blood / Q000134:cerebrospinal fluid; D001927:Brain Diseases / Q000175:diagnosis*; D002675:Child, Preschool; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009414:Nerve Growth Factors / Q000032:analysis* / Q000097:blood / Q000134:cerebrospinal fluid; D010751:Phosphopyruvate Hydratase / Q000032:analysis* / Q000097:blood / Q000134:cerebrospinal fluid; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000032:analysis* / Q000097:blood / Q000134:cerebrospinal fluid; D012640:Seizures / Q000175:diagnosis*; D003294:Seizures, Febrile / Q000175:diagnosis; D016875:tau Proteins / Q000032:analysis* / Q000097:blood / Q000134:cerebrospinal fluid
chemical_list: D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human; D016875:tau Proteins; D010751:Phosphopyruvate Hydratase