Department of Neurology with Institute of Translational Neurology, University of Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Münster, Germany; Department of Neurology, Klinikum Osnabrück, Am Finkenhügel 1, 49076 Osnabrück, Germany.
Department of Neurology with Institute of Translational Neurology, University of Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Münster, Germany.
Seizure. 2021 Oct;91:233-243. doi: 10.1016/j.seizure.2021.06.030. Epub 2021 Jun 29.
Patients with seizures and epilepsy routinely undergo multiple diagnostic tests, which may include cerebrospinal fluid (CSF) analysis. This review aims to outline different CSF parameters and their alterations in seizures or epilepsy. We then discuss the utility of CSF analysis in seizure patients in different clinical settings in depth. Some routine CSF parameters are frequently altered after seizures, but are not specific such as CSF protein and lactate. Pleocytosis and CSF specific oligoclonal bands are rare and should be considered as signs of infectious or immune mediated seizures and epilepsy. Markers of neuronal damage show conflicting results, and are as yet not established in clinical practice. Parameters of neuronal degeneration and more specific immune parameters are less well studied, and are areas of further research. CSF analysis in new-onset seizures or status epilepticus serves well in the differential diagnosis of seizure etiology. Here, considerations should include autoimmune-associated seizures. CSF findings in these disorders are a special focus of this review and are summarized in a comprehensive overview. Until now, CSF analysis has not yielded clinically helpful biomarkers for refractory epilepsy or for assessment of neuronal damage which is a subject of further studies.
患者的癫痫发作和癫痫通常需要进行多次诊断测试，其中可能包括脑脊液（CSF）分析。本综述旨在概述不同的 CSF 参数及其在癫痫发作或癫痫中的变化。然后，我们深入讨论了 CSF 分析在不同临床环境中癫痫发作患者的应用。一些常规 CSF 参数在癫痫发作后经常发生变化，但并不具有特异性，如 CSF 蛋白和乳酸。CSF 中的细胞增多和特定寡克隆带很少见，应被视为感染或免疫介导的癫痫发作和癫痫的迹象。神经元损伤的标志物显示出相互矛盾的结果，在临床实践中尚未确立。神经元退化和更特异性免疫参数的参数研究较少，是进一步研究的领域。CSF 分析在新发癫痫发作或癫痫持续状态中有助于鉴别癫痫发作的病因。在这里，需要考虑的是自身免疫性相关的癫痫发作。这些疾病中的 CSF 发现是本综述的一个特别关注点，并在全面概述中进行了总结。到目前为止，CSF 分析尚未为耐药性癫痫或评估神经元损伤提供有临床意义的生物标志物，这是进一步研究的主题。
