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Cerebrospinal fluid pleocytosis following simple, complex partial, and generalized tonic-clonic seizures
O Devinsky1, S Nadi, W H Theodore
1Medical Neurology Branch, National Institutes of Health, Bethesda, MD 20892.
Insights
Postictal pleocytosis, an increase in cerebrospinal fluid leukocytes, can occur after various epilepsy seizure types. This finding was more frequent in samples collected within 12 hours of a seizure.
Area of Science:
- Neurology
- Neuroscience
- Clinical Medicine
Background:
- Epilepsy is a neurological disorder characterized by recurrent seizures.
- Cerebrospinal fluid (CSF) analysis is crucial for diagnosing neurological conditions.
- Postictal pleocytosis, an elevation of white blood cells in CSF after a seizure, has been documented but its occurrence across different seizure types requires further clarification.
Purpose of the Study:
- To investigate the incidence and characteristics of postictal pleocytosis in patients with epilepsy.
- To determine if postictal pleocytosis is associated with specific seizure types or timing relative to the last seizure.
Main Methods:
- Analysis of 62 cerebrospinal fluid specimens from 27 patients diagnosed with epilepsy.
- Exclusion of patients with alternative causes for pleocytosis.
- Cellular counts (leukocytes and erythrocytes) in CSF were quantified.
Main Results:
- Postictal pleocytosis was observed in 7 out of 62 CSF specimens (11.3%).
- Maximum leukocyte count was 12/mm³, and maximum erythrocyte count was 190/mm³.
- Pleocytosis was more prevalent in CSF samples obtained within 12 hours of the last seizure.
Conclusions:
- Postictal pleocytosis can occur following various seizure types in epilepsy, including single simple, complex partial, and generalized tonic-clonic seizures.
- The presence of pleocytosis is more likely when CSF is collected shortly after a seizure event.
- These findings expand the understanding of CSF changes in epilepsy beyond repetitive generalized tonic-clonic seizures.
Abstract:
We observed postictal pleocytosis in 7 of 62 cerebrospinal fluid specimens obtained from 27 patients with epilepsy. Each patient had a known seizure disorder; none had any other cause for the pleocytosis. The maximum number of leukocytes was 12/mm3; the maximum number of erythrocytes was 190/mm3. Postictal pleocytosis was more common in samples obtained within 12 hours of the last seizure. Although previous studies have emphasized that pleocytosis is more common after repetitive generalized tonic-clonic seizures, we found increased leukocyte counts in cerebrospinal fluid after single simple, complex partial, or generalized tonic-clonic seizures.