The fluctuations of neuron-specific enolase (NSE) levels of cerebrospinal fluid during bacterial meningitis: the relationship between the fluctuations of NSE levels and neurological complications or outcome.

Neuron-specific enolase (NSE) is one of the glycolytic enzymes distributed exclusively in neurons. It was measured serially in the cerebrospinal fluid (CSF) of 10 children with bacterial meningitis during the illness using radio-immunoassay. The relationship between CSF-NSE levels and neurological complications or outcome was examined. CSF-NSE levels were significantly higher in the patients with bacterial meningitis than in the patients with the other central nervous system (CNS) infectious diseases, suggesting that CNS damage in those patients with bacterial meningitis was exacerbated. As CSF-NSE levels increased to above 25 ng/mL in the acute phase, all patients except one had subdural effusion. In those patients whose CSF-NSE level rose again during the illness, CNS complications or sequelae occurred. CSF-NSE may be a useful prognostic factor for predicting CNS damage in childhood bacterial meningitis.