Abstracts

RATIONALE: Neuron-specific enolase (NSE) has been proposed to be a useful marker for evaluating the degree of neuronal damage and prognosis in acute neurologic insults. Elevated levels of NSE have been found in status epilepticus, but also after single epileptic seizures. The purpose of this study was to examine serum and cerebrospinal fluid (CSF) NSE in children with febrile (FSE) and afebrile status epilepticus (ASE) and to evaluate association of NSE with later neurologic prognosis.
METHODS: Twenty-five consecutive, previously healthy children with their first status epilepticus (SE) lasting 30 minutes or more were prospectively studied. Children with previous neurologic problems, seizure history or known risk factors to seizures were excluded. CSF and serum samples for NSE analysis were simultaneously collected at the acute stage and at two weeks and serial serum samples at 24 and 48 hours. Follow-up protocol included neuroradiologic, neurologic and neuropsychologic examinations.
RESULTS: One FSE and one ASE child showed increased serum NSE value ([gt]12.5 ug/l) at admission and at 24 hours. Two FSE children had increased serum NSE both at 24 and 48 hours and one more FSE child only in serum sample at 24 hours. One of these five children had SE duration of 37 minutes and all others more than 60 minutes; only one of them had acute changes on cerebral MRI. All CSF-NSE values were within normal limits. During follow-up from 22 to 64 months nobody of the children with elevated NSE has shown later seizures or neurodevelopmental problems.
CONCLUSIONS: Increased serum NSE seemed to be associated with relatively long SE but both seizure and neurodevelopmental prognosis seemed to be good.