Cerebrospinal fluid and serum NT-proBNP concentrations in children with epilepsy

The cardio-neuro-endocrine axis seems to be involved in the cascade of postictal events in children. The aim of this study was to assess the relationship between childhood epilepsy and cerebrospinal fluid (CSF) or serum concentrations of the N-terminal pro B-type natriuretic peptide (NT-proBNP) interictally.

A total of seventy-four children agreed to participate in the study. Twenty-two children with epilepsy and mild developmental delay (mean+/-SD [median] age 5.8+/-4.9 [4.3] years), 15 children with newly diagnosed multiple sclerosis (MS) (15.1+/-1.4 [15.3] years) and 37 children with cryptogenic mild developmental delay (8.0+/-4.6 [7.4] years), serving as controls, were eligible.

In children with epilepsy, interictal CSF NT-proBNP concentrations were greater when compared to the MS group and to controls (mean+/-SD [median] 193.0+/-78.1 [176.0]ng/L vs. 147.8+/-60.2 [138.0]ng/L vs. 140.4+/-36.5 [134.0]ng/L; p=0.014 and p=0.009). In contrast, serum NT-proBNP concentrations and the CSF/serum NT-proBNP ratio did not differ between groups.

Greater CSF NT-proBNP concentrations in children with epilepsy may reflect an unspecific activation of the cardio-neuro-endocrine system involving endocrinological stress-response mechanisms interictally. The relationship between epilepsy and the cardio-neuro-endocrine axis may further the understanding of seizure susceptibility in children as well as influences of epilepsy on central modulation of autonomic cardiovascular control.