Rodríguez-Núñez A, Cid E, Rodríguez-García J, Camiña F, Rodríguez-Segade S, Castro-Gago M
Department of Pediatrics, Hospital ClInico Universitario, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain.
Brain Dev. 2000 Oct;22(7):427-31. doi: 10.1016/s0387-7604(00)00172-8.
If febrile seizures cause significant compromise of neuronal metabolism (whether permanent or reversible), this should be reflected in an increase in the cerebrospinal fluid concentrations of neuron-specific enolase (NSE) and/or adenosine triphosphate (ATP) breakdown products. In the present study, AMP, IMP, inosine, adenosine, guanosine, adenine, guanine, hypoxanthine, xanthine, uric acid and NSE concentrations were determined in the cerebrospinal fluid of 90 children 1 h after febrile seizure (73 simple febrile seizures (SFS); 17 complex febrile seizures (CFS)), and in a control group of 160 children. There was no statistically significant difference between the SFS group and the control group for any of the substances determined, suggesting that SFS neither significantly depletes neuronal ATP concentration, nor significantly increases NSE concentration; thus, SFS do not appear to constitute a threat to neuronal integrity. However, patients with CFS showed significantly lower IMP concentrations and significantly higher adenine concentrations than controls, and significantly higher AMP concentrations than SFS patients; these results suggest that CFS may affect energy metabolism in the brain. However, NSE concentrations were normal in the cerebrospinal fluid of both SFS and CFS patients, suggesting that neither type of seizure causes significant neuronal damage, at least early after the seizure.
如果热性惊厥导致神经元代谢显著受损(无论是永久性还是可逆性),这应反映在脑脊液中神经元特异性烯醇化酶(NSE)和/或三磷酸腺苷(ATP)分解产物浓度的升高上。在本研究中,测定了90例热性惊厥发作后1小时儿童(73例单纯热性惊厥(SFS);17例复杂性热性惊厥(CFS))以及160例儿童对照组脑脊液中的AMP、IMP、肌苷、腺苷、鸟苷、腺嘌呤、鸟嘌呤、次黄嘌呤、黄嘌呤、尿酸和NSE浓度。所测定的任何一种物质在SFS组和对照组之间均无统计学显著差异,这表明SFS既不会显著消耗神经元ATP浓度,也不会显著增加NSE浓度;因此,SFS似乎不会对神经元完整性构成威胁。然而,CFS患者的IMP浓度显著低于对照组,腺嘌呤浓度显著高于对照组,AMP浓度显著高于SFS患者;这些结果表明CFS可能会影响大脑中的能量代谢。然而,SFS和CFS患者脑脊液中的NSE浓度均正常,这表明至少在惊厥发作后早期,这两种类型惊厥均不会导致显著的神经元损伤。