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NEUROLOGY 1979;29:467
© 1979 American Academy of Neurology

Reye syndrome

Monoamine metabolites in ventricular fluid

Bennett A. Shaywitz, M.D., Joan Venes, M.D., Donald J. Cohen, M.D. and Malcolm B. Bowers, M.D.

Departments of Pediatrics, Neurology, Neurosurgery and Psychiatry, and the Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut.

Concentrations of homovanillic acid (HVA) were markedly elevated in the ventricular fluid of 15 children with Reye syndrome (median, 887 ng per milliliter) compared to 7 controls (median, 282 ng per milliliter), but 5-hydroxyindoleacetic acid (5-HIAA) values were comparable (medians of 198 and 189 ng per milliliter, respectively). The ratio of 5-HIAA to HVA was significantly lower in patients with Reye syndrome (0.26) than in controls (0.51). Serial samples demonstrated wide fluctuations in HVA concentration, but not in that of 5-HIAA. Monoamine metabolite concentrations were not correlated with serum ammonia, increased intracranial pressure, morbidity, or mortality. Increased HVA in Reye syndrome may reflect cerebral ischemia and release of vasoactive amines (particularly dopamine) into the brain and cerebrospinal fluid (CSF).

Dr. Shaywitz's address is Department of Pediatrics and Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven CT 06510.

This work was supported by Grant No. PHS NS-12384, Children's Clinical Research Center, Grant No. RR00125, The Grant Foundation of New York, and by Mr. Leonard Berger.

Accepted for publication June 19, 1978.






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