5-HIAA in Cerebrospinal Fluid of Patients with Status Epilepticus

The effects of status epilepticus on the orexin/hypocretin system have yet to be investigated. The present study aimed to assay orexin-A/hypocretin-1 in the cerebrospinal fluid (CSF) of patients after generalized convulsive status epilepticus (GCSE). The study groups included 20 GCSE patients, 24 patients diagnosed with epilepsy but remaining in remission (ER), and 25 normal controls (CTR). Diagnostic lumbar puncture was performed in GCSE patients within 3–10 days of seizure cessation, as well as in the ER and to CTR subjects. Among all GCSE patients, the outcome was graded according to the modified Rankin Scale (mRS) at 1-month follow-up. Orexin-A levels were measured in unextracted CSF samples, using a commercial radioimmunoassay. There was a significant overall difference in median CSF orexin-A concentrations between GCSE, RE, and CTR patients (p < 0.001). The lowest concentrations were noted in the GCSE group compared to ER (p < 0.001) or CTR (p < 0.001). CSF orexin-A levels in GCSE patients inversely correlated with clinical outcome as assessed on the mRS at 1-month follow-up (r = −0.55; p = 0.1). In conclusion, CSF orexin-A levels may serve as a biomarker of increased turn-over of the peptide or post-SE neuronal damage, and implicates the orexin system in the pathogenesis of SE.

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Nonconvulsive Status Epilepticus on Electroencephalography: An Atypical Presentation of Subacute Sclerosing Panencephalitis in Two Children

Case Reports in Pediatrics ◽

10.1155/2012/374232 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Pratibha Singhi ◽

Arushi Gahlot Saini ◽

Jitendra Kumar Sahu

Keyword(s):

Cerebrospinal Fluid ◽

Status Epilepticus ◽

Cognitive Decline ◽

Neurodegenerative Disease ◽

Slow Wave ◽

Subacute Sclerosing Panencephalitis ◽

Nonconvulsive Status Epilepticus ◽

Atypical Presentation ◽

Measles Antibodies

Subacute sclerosing panencephalitis is a neurodegenerative disease secondary to measles infection that usually has a typical presentation with progressive myoclonia, cognitive decline, and periodic slow-wave complexes on electroencephalography. We report two pediatric cases who presented with periodic myoclonic jerks and cognitive decline. In both cases, the electroencephalogram showed continuous nonconvulsive status epilepticus activity. Both had elevated measles antibodies in cerebrospinal fluid and blood. Pediatricians need to be aware of this atypical presentation of subacute sclerosing panencephalitis.

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Partial Status Epilepticus with Paradoxical Protein-Cytologic Dissociation in Cerebrospinal Fluid

International Journal of Epilepsy ◽

10.1055/s-0040-1716432 ◽

2020 ◽

Author(s):

Neeraj Singh ◽

John J. Lansing ◽

Aparna Polavarapu

Keyword(s):

Central Nervous System ◽

Cerebrospinal Fluid ◽

Nervous System ◽

Status Epilepticus ◽

Central Nervous System Infection ◽

Case Series ◽

Refractory Status Epilepticus ◽

Multiple Drug ◽

High Morbidity ◽

Drug Interventions

AbstractStatus epilepticus is associated with high morbidity and mortality, often requiring multiple drug interventions and intensive care monitoring. Etiology of status epilepticus plays a crucial role in the treatment, natural course and outcome of the patient, prompting extensive testing and imaging. For example, an important risk for status epilepticus in adults and children is the presence of an underlying viral or bacterial central nervous system infection, appropriate treatment of which can improve the outcome of the patient. We present three cases of new-onset refractory status epilepticus in women who did not have evidence of a central nervous system infection and had significantly elevated leukocytes compared to protein in the cerebrospinal fluid. This finding suggests an autoimmune etiology; however, standard autoimmune testing was unremarkable in all cases. This case series highlights the variability in presentation and clinical course in patients presenting with status epilepticus of unknown cause, and we discuss the importance of further research into appropriate and reliable diagnostic evaluations.

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