Decreased Cerebrospinal Fluid Orexin-A (Hypocretin-1) Concentrations in Patients after Generalized Convulsive 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.

Download Full-text

Continuous EEG monitoring in the follow-up of convulsive status epilepticus patients: A proposal and preliminary validation of an EEG-based seizure build-up score (EaSiBUSSEs)

Neurophysiologie Clinique ◽

10.1016/j.neucli.2021.01.006 ◽

2021 ◽

Author(s):

Aurélie Hanin ◽

Sophie Demeret ◽

Vi-Huong Nguyen-Michel ◽

Virginie Lambrecq ◽

Vincent Navarro

Keyword(s):

Status Epilepticus ◽

Convulsive Status Epilepticus ◽

Eeg Monitoring ◽

Preliminary Validation ◽

Continuous Eeg ◽

Continuous Eeg Monitoring

Download Full-text

Decreased cerebrospinal fluid hypocretin-1 (orexin A) in patients after repetitive generalized tonic-clonic seizures

Epilepsia ◽

10.1111/j.1528-1167.2008.01990.x ◽

2009 ◽

Vol 50 (6) ◽

pp. 1641-1644 ◽

Cited By ~ 20

Author(s):

Konrad Rejdak ◽

Ewa Papuć ◽

Paweł Grieb ◽

Zbigniew Stelmasiak

Keyword(s):

Cerebrospinal Fluid ◽

Orexin A ◽

Clonic Seizures ◽

Hypocretin 1

Download Full-text

Cerebrospinal fluid orexin-A levels in systemic lupus erythematosus patients presenting with excessive daytime sleepiness

Lupus ◽

10.1177/0961203318778767 ◽

2018 ◽

Vol 27 (11) ◽

pp. 1847-1853 ◽

Cited By ~ 2

Author(s):

K Suzuki ◽

M Miyamoto ◽

T Miyamoto ◽

T Matsubara ◽

Y Inoue ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Cerebrospinal Fluid ◽

Lupus Erythematosus ◽

Excessive Daytime Sleepiness ◽

Daytime Sleepiness ◽

Acute Stage ◽

Systemic Lupus ◽

Orexin A ◽

Hypothalamic Lesions

Objective Involvement of the hypothalamus is rare in patients with systemic lupus erythematosus (SLE). In this study, we measured cerebrospinal fluid (CSF) orexin-A levels in SLE patients with hypothalamic lesions to investigate whether the orexin system plays a role in SLE patients with hypothalamic lesions who present with excessive daytime sleepiness (EDS). Methods Orexin-A levels were measured in CSF from four patients with SLE who presented with hypothalamic lesions detected by MRI. Three patients underwent repeated CSF testing. All patients met the updated American College of Rheumatology revised criteria for SLE. Results Tests for serum anti-aquaporin-4 antibodies, CSF myelin basic protein and CSF oligoclonal bands were negative in all patients. All patients presented with EDS. Low to intermediate CSF orexin-A levels (92–180 pg/ml) were observed in three patients in the acute stage, two of whom (patients 1 and 2) underwent repeated testing and showed increased CSF orexin-A levels, reduced abnormal hypothalamic lesion intensities detected by MRI and EDS dissipation at follow-up. In contrast, CSF orexin-A levels were normal in one patient (patient 4) while in the acute stage and at follow-up, despite improvements in EDS and MRI findings. Patient 4 showed markedly increased CSF interleukin-6 levels (1130 pg/ml) and a slightly involved hypothalamus than the other patients. Conclusions Our findings suggest that the orexinergic system has a role in EDS in SLE patients with hypothalamic lesions. Furthermore, cytokine-mediated tissue damage might cause EDS without orexinergic involvement.

Download Full-text

Subcortical nuclei volumes are associated with cognition in children post-convulsive status epilepticus: Results at nine years follow-up

Epilepsy & Behavior ◽

10.1016/j.yebeh.2020.107119 ◽

2020 ◽

Vol 110 ◽

pp. 107119

Author(s):

Kyle H. Bennett ◽

Suresh S. Pujar ◽

Marina M. Martinos ◽

Christopher A. Clark ◽

Michael Yoong ◽

...

Keyword(s):

Status Epilepticus ◽

Convulsive Status Epilepticus ◽

Subcortical Nuclei

Download Full-text

Status epilepticus as presenting manifestation of H1N1 infection

International Journal of Epilepsy ◽

10.1016/j.ijep.2014.06.002 ◽

2015 ◽

Vol 02 (02) ◽

pp. 084-086 ◽

Cited By ~ 1

Author(s):

Aastha Takkar ◽

Manoj Goyal ◽

Manish Modi ◽

Parampreet Kharbanda ◽

Lakshminarayana Yaddanapudi ◽

...

Keyword(s):

Status Epilepticus ◽

Antiviral Treatment ◽

Neurological Complications ◽

Clinical Findings ◽

Convulsive Status Epilepticus ◽

H1n1 Pandemic ◽

H1n1 Infection ◽

Serological Tests ◽

History Of

Abstract Background During the global H1N1 pandemic, neurological complications were reported in approximately 6–10% of children suffering from H1N1 infection, but only rarely in adults. Generalized convulsive status epilepticus (GCSE) as a presenting manifestation of H1N1 infection in an adult is exceedingly rare and has not been reported in literature. We report a patient who presented to us with GCSE as a presenting manifestation of H1N1 infection who improved following appropriate antiviral treatment. Methods and results This 20-year-old gentleman presented to us with history of fever followed by GCSE of 24 h duration. He was treated symptomatically and was evaluated in detail. He was diagnosed to be suffering from H1N1 infection based on appropriate serological tests. After start of antiviral therapy, he improved and is doing well at 4 months follow up. Conclusion This case report further expands the spectrum of clinical findings associated with sporadic H1N1 infection. A possibility of H1N1 infection should be considered in all patients who present with GCSE without any obvious cause so that appropriate diagnostic tests and treatment can be carried out at the earliest.

Download Full-text