Serum neuron-specific enolase: A marker for neuronal injury in children with convulsive status epilepticus

Abstract

Status epilepticus (SE) represents a medical emergency that is associated with a high morbidity and mortality. The most accepted definition of SE is a condition during which epileptic activity persists for 30 min or longer or is repeated fre- quently enough that the individual does not regain consciousness between seizures. Neuron-specific enolase (NSE) is a marker of acute brain injury and blood-brain barrier dysfunction, which is elevated in SE. Serum NSE is an accepted marker of acute brain injury, and an increase in NSE has been correlated with the duration and outcome of generalized convulsive SE. Increase in serum NSE in generalized convulsive SE would provide new information about the degree of brain injury in generalized con- vulsive SE. The aim of this study was to evaluate whether convulsive SE causes brain damage or not, based on the serum levels of NSE and to determine the correlation between the serum NSE and the duration of SE. Thirty children with convulsive SE, 20 males and 10 females with the age range 6-14 yr and the mean age was (9.1 ± 2.3 yr). Thirty healthy children 18 males and 12 females with a similar age distribution and sex, their age range was 8-14 yr and the mean age was (9.9 ± 1.6 yr) served as the control children. Twenty children with idiopathic epilepsy 15 males and five females, newly diagnosed suffering from various types of seizures generalized and partial types, aged 1 yr to 14 yr with the mean age was 10.1 ± 3.1 yr for comparison. Serum NSE levels were measured in children with SE 24 hr after the control of seizures and compared with the control children and children with idiopathic epilepsy, the duration of SE was determined and correlated with the peak NSE level. The mean serum NSE was significantly higher in children with convulsive SE than the control children and children with idiopathic epilepsy (P < 0.001), also there was significant correlation between the serum NSE and the duration of seizures in children with SE. Children with convulsive SE had significantly higher serum levels of NSE than the control children. The extremely higher levels of NSE in convulsive SE reflect the severity of the acute neurological insults. In addition, higher serum NSE levels in generalized convulsive SE reflect the long duration of SE and the potential for brain injury.