Kiviranta T, Tuomisto L, Jolkkonen J, Airaksinen E M
Department of Paediatrics, Kuopio University Hospital, Finland.
Brain Dev. 1996 Mar-Apr;18(2):110-3. doi: 10.1016/0387-7604(95)00146-8.
Immaturity in water and electrolyte balance in the brain has been considered to increase the susceptibility of young animals and children to febrile convulsions (FCs). Arginine-vasopressin (AVP) is involved in the regulation of several centrally mediated events such as modulation of fever and the ease with which water permeates into and out of the brain. To evaluate the possible role of AVP in the control of water balance and susceptibility to convulsions during fever we measured the AVP concentration in the cerebrospinal fluid (CSF) and plasma of febrile children with or without convulsions. The febrile population consisted of 47 children, of whom 29 experienced seizures during fever. Seven children with epileptic symptoms and 18 children without seizures were included as nonfebrile controls. The CSF AVP concentration in febrile children without seizures and in nonfebrile convulsive children was significantly lower (0.60 +/- 0.07 pmol/l, mean +/- SEM, P < 0.01 and 0.65 +/- 0.19 pmol/l, P < 0.05, respectively) than in nonfebrile children without convulsions (0.83 +/- 0.06 pmol/l). However, the levels of CSF AVP were not significantly different in children with FCs (0.71 +/- 0.06 pmol/l) compared with other groups. CSF AVP correlated with the CSF osmolality (r = 0.33, P = 0.02). No statistical differences in plasma AVP levels between the groups could be found. The present data provide support for the hypothesis of synchronous regulation of osmolality and AVP concentration in CSF. During fever the concentration of CSF AVP was lower in nonconvulsive children compared with nonfebrile nonconvulsive children. CSF AVP levels were not affected in febrile children by convulsions.
大脑中水电解质平衡的不成熟被认为会增加幼小动物和儿童患热性惊厥（FCs）的易感性。精氨酸加压素（AVP）参与多种中枢介导事件的调节，如发热的调节以及水进出大脑的难易程度。为了评估AVP在发热期间对水平衡控制和惊厥易感性中的可能作用，我们测量了有或无惊厥的发热儿童脑脊液（CSF）和血浆中的AVP浓度。发热人群包括47名儿童，其中29名在发热期间出现惊厥。7名有癫痫症状的儿童和18名无惊厥的儿童作为非发热对照。无惊厥的发热儿童和非发热惊厥儿童的脑脊液AVP浓度显著低于无惊厥的非发热儿童（分别为0.60±0.07 pmol/l，平均值±标准误，P<0.01和0.65±0.19 pmol/l，P<0.05）（0.83±0.06 pmol/l）。然而，与其他组相比，FCs儿童的脑脊液AVP水平无显著差异（0.71±0.06 pmol/l）。脑脊液AVP与脑脊液渗透压相关（r = 0.33，P = 0.02）。各组之间血浆AVP水平未发现统计学差异。目前的数据支持脑脊液渗透压和AVP浓度同步调节的假说。发热期间，非惊厥儿童的脑脊液AVP浓度低于非发热非惊厥儿童。惊厥对发热儿童的脑脊液AVP水平没有影响。
