Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, 146-92 Dogok-dong, Gangnam-gu, Seoul, 135-720, Korea.
J Neurol. 2010 Oct;257(10):1708-12. doi: 10.1007/s00415-010-5608-2. Epub 2010 Jun 8.
Patients who experience a single generalized tonic-clonic seizure or syncope may have similar clinical symptoms, which can cause difficulty in the differential diagnosis. The aim of this study was to examine whether serum neuron-specific enolase (NSE) has diagnostic relevance as a biochemical marker for these disorders. Serum NSE levels were analyzed following a loss of consciousness in patients who were diagnosed with a seizure (n = 52) and syncope (n = 42) compared with normal controls (n = 91). NSE was 14.97 ± 7.57 ng/dl for the seizure group, 10.15 ± 3.22 ng/dl for the syncope group, and 10.03 ± 1.28 ng/dl for the control group. The seizure group showed a significantly increased serum NSE (p < 0.05) compared to the syncope and control groups. By receiver operating characteristic (ROC) curve analysis, the cut-off value with the highest diagnostic accuracy was defined as 11.5 ng/ml with a sensitivity of 0.58 and specificity of 0.91. The NSE values of the syncope and control groups showed no significant differences. Syncope may not influence diffuse brain damage. Serum NSE measurement may be a helpful test for the identification and diagnosis of a seizure rather than syncope.
患有单次全面强直阵挛发作或晕厥的患者可能具有相似的临床症状,这可能导致鉴别诊断困难。本研究旨在探讨血清神经元特异性烯醇化酶(NSE)是否可作为这些疾病的生化标志物具有诊断相关性。对诊断为癫痫(n=52)和晕厥(n=42)的患者和正常对照组(n=91)在出现意识丧失后分析血清 NSE 水平。癫痫组的 NSE 为 14.97±7.57ng/dl,晕厥组为 10.15±3.22ng/dl,对照组为 10.03±1.28ng/dl。与晕厥组和对照组相比,癫痫组的血清 NSE 显著升高(p<0.05)。通过受试者工作特征(ROC)曲线分析,定义最高诊断准确性的截断值为 11.5ng/ml,其灵敏度为 0.58,特异性为 0.91。晕厥组和对照组的 NSE 值无显著差异。晕厥可能不会影响弥漫性脑损伤。血清 NSE 测量可能有助于识别和诊断癫痫而非晕厥。