Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Arnold-Heller-Str. 3, 24105 Kiel, Germany.
Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105 Kiel, Germany.
Seizure. 2024 Oct;121:91-94. doi: 10.1016/j.seizure.2024.08.006. Epub 2024 Aug 5.
To detect possible neuronal damage due to recurrent isolated seizures in patients with epilepsy in a clinical routine setting.
We measured the serum concentrations of neurofilament light chain (sNfL) in 46 outpatients with an at least monthly occurrence (self-reported) of generalized tonic-clonic seizures in the six months prior to the study and in 49 patients who had been seizure free (self-reported) for at least one year. We assigned the patients with seizure activity into groups with moderate and high seizure frequency. We measured sNfL with a highly sensitive single molecule array (Simoa).
The majority (94 %) of all patients with epilepsy had sNfL values within the age adjusted reference ranges of our laboratory. Three patients with and three patients without seizure activity (each 3 %) showed elevated sNfL concentrations. Age adjusted sNfL concentrations did not differ significantly between patients with and without seizure activity in the total sample or in the female subgroup. In contrast, NfL concentrations were significantly higher in male patients with seizure activity and highest in the subgroup of those with high seizure activity, but were only above the reference range in two patients. sNfL concentrations did not differ between focal and generalized epilepsies and between genetic and structural etiologies.
The sNfL concentrations in patients with epilepsy and healthy patients did not differ significantly. The finding of higher sNfL concentrations in males with self-reported seizure activity should be viewed with utmost caution because the difference was small and only two male patients showed sNfL concentrations above the reference range.
在临床常规环境中，检测癫痫患者反复发作孤立性癫痫后可能出现的神经元损伤。
我们测量了 46 例至少每月（自我报告）发生全身性强直阵挛性癫痫发作的门诊患者和 49 例至少一年无癫痫发作（自我报告）的患者的血清神经丝轻链（sNfL）浓度。我们将有癫痫发作活动的患者分为中度和高度癫痫发作频率组。我们使用高度敏感的单分子阵列（Simoa）测量 sNfL。
所有癫痫患者中，绝大多数（94%）的 sNfL 值均在我们实验室的年龄校正参考范围内。有 3 例有癫痫发作活动的患者和 3 例无癫痫发作活动的患者（各 3%）显示出 sNfL 浓度升高。在总样本或女性亚组中，有和无癫痫发作活动的患者的年龄校正 sNfL 浓度无显著差异。相比之下，有癫痫发作活动的男性患者的 NfL 浓度显著升高，且在高癫痫发作活动亚组中最高，但仅有 2 例患者的浓度高于参考范围。sNfL 浓度在局灶性和全身性癫痫之间以及遗传和结构性病因之间无差异。
癫痫患者和健康患者的 sNfL 浓度无显著差异。有自我报告癫痫发作活动的男性患者 sNfL 浓度升高的发现应谨慎看待，因为这种差异很小，只有 2 例男性患者的 sNfL 浓度高于参考范围。
