Serum CPK-BB isoenzyme in the assessment of brain damage in asphyctic term infants

Serum creatine phosphokinase-BB activities were measured at 4 and at 10 hours of life in 33 asphyctic full-term infants. The infants were followed for a mean period of 16 months. Enzyme activities at 4 hours of life were significantly higher in those neonates who died of severe hypoxic-ischemic encephalopathy or developed neurological sequelae than in those who did not present neurological abnormalities during the follow-up time. The specificity of the enzyme assay in order to predict the neurological outcome was inferior to that of cranial computed tomography or a combined clinical-electroencephalographic evaluation. It appears that the presence of elevated serum creatine phosphokinase-BB activity can be a sensitive indicator of conspicuous brain damage, but it is of limited value to predict the neurological outcome after neonatal asphyxia.