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Pleocytosis after status epilepticus

E Barry1, W A Hauser

  • 1Department of Neurology, University of Maryland, Baltimore.

Archives of Neurology
|February 1, 1994
PubMed
Summary
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Pleocytosis, indicated by elevated white blood cell (WBC) counts in cerebrospinal fluid (CSF), can occur with status epilepticus (SE). However, the underlying cause of SE is the primary driver of CSF abnormalities, not SE itself.

Area of Science:

  • Neurology
  • Neuroscience
  • Clinical Medicine

Background:

  • Status epilepticus (SE) is a neurological emergency.
  • Cerebrospinal fluid (CSF) analysis is crucial for diagnosing conditions associated with SE.
  • Pleocytosis, an increase in white blood cells (WBCs) in CSF, can indicate inflammation or infection.

Purpose of the Study:

  • To determine the incidence of pleocytosis in patients experiencing status epilepticus (SE).
  • To assess the relationship between SE and cerebrospinal fluid (CSF) white blood cell (WBC) counts.
  • To differentiate pleocytosis caused by SE from other underlying etiologies.

Main Methods:

  • Retrospective medical chart review of 138 patients with SE.
  • Analysis of cerebrospinal fluid (CSF) findings, including white blood cell (WBC) counts and differential.

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  • Inclusion of all seizure types and etiologies of SE.

    • Main Results:

    • Overall, 22.5% of patients with SE exhibited abnormal CSF WBC counts or morphology.
    • 15% of patients had elevated CSF WBC counts (≥ 6 x 10^6/L).
    • Abnormalities were more common and severe in SE cases with known inflammatory or infectious causes (e.g., meningitis, head trauma).

    Conclusions:

    • The underlying cause of status epilepticus (SE) is the primary determinant of cerebrospinal fluid (CSF) white blood cell (WBC) abnormalities.
    • While minor CSF WBC elevations can occur post-SE, pleocytosis should not be solely attributed to SE without excluding other causes.
    • Thorough etiological investigation is essential in patients with SE presenting with pleocytosis.