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Neurology 1999;53:1761
© 1999 American Academy of Neurology
Articles

Serum and CSF neuron-specific enolase in patients with West syndrome

Y. Suzuki, MD, Y. Toribe, MD, M. Goto, MD, T. Kato, MD and Y. Futagi, MD

From the Division of Pediatric Neurology, Osaka Medical Center and Research Institute for Maternal and Child Health, Japan.

Address correspondence and reprint requests to Dr. Y. Suzuki, Division of Pediatric Neurology, Osaka Medical Center and Research Institute for Maternal and Child Health, 840, Murodo-cho, Izumi, Osaka 594-1101, Japan.

OBJECTIVE: To determine whether frequent seizures and/or hypsarrhythmia may cause neuronal injury in West syndrome.

BACKGROUND: West syndrome is an age-related epileptic syndrome of infancy characterized by clusters of epileptic spasms, a peculiar interictal EEG pattern of hypsarrhythmia, and mental deterioration. Recent clinical studies demonstrated that serum and CSF neuron-specific enolase (NSE)—a marker of neuronal injury—were increased after status epilepticus.

METHODS: The authors examined serum and CSF NSE levels in 18 newly diagnosed infants (8.4 ± 2.2 months) with West syndrome (3 cryptogenic, 15 symptomatic). In patients who showed complete resolution of spasms and disappearance of hypsarrhythmia (responders), additional serum NSE levels were determined several weeks after cessation of seizures. Serum NSE levels were obtained from 28 age-matched infants with normal neurologic development (control group), and 10 infants with an acute neurologic insult.

RESULTS: There were no significant differences (p > 0.05) in serum NSE levels between the group with West syndrome (12.9 ± 3.4 ng/mL) and the control group (13.2 ± 3.1 ng/mL). The serum NSE value in the group with an acute insult (100.3 ± 67.4 ng/mL) was significantly higher (p < 0.0001) than that for the West syndrome and the control groups. The mean ± SD CSF NSE level was 7.3 ± 3.6 ng/mL, which is similar to the reported CSF NSE levels of Japanese infants without neurologic disease. Thirteen responders showed no significant (p > 0.05) change in serum NSE after cessation of epileptic spasms.

CONCLUSION: Normal serum and CSF neuron-specific enolase levels provided no evidence that seizures and/or hypsarrhythmia induced neuronal injury in West syndrome.

Key words: Infantile spasms—West syndrome—Neuron-specific enolase.




This article has been cited by other articles:


Home page
 J Child NeurolHome page
M. Wong, K. Ess, and M. Landt
Cerebrospinal Fluid Neuron-Specific Enolase Following Seizures in Children: Role of Etiology
J Child Neurol, April 1, 2002; 17(4): 261 - 264.
[Abstract] [PDF]


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