Elevated serum neuron-specific enolase in patients with temporal lobe epilepsy: A video-EEG study

SummaryEstablished markers of brain damage, neuron-specific enolase (NSE) and S-100b protein (S-100), may increase after status epilepticus, but whether a single tonic-clonic or complex partial seizure induces elevation of these markers is not known. Furthermore, it is unclear whether the risk of seizure-related neuronal damage in temporal lobe epilepsy (TLE) differs from that in extratemporal lobe epilepsies (XTLE). The aim of this study was to analyze NSE and S-100 in patients with TLE and XTLE after acute seizures. The levels of NSE and S-100 were measured in serum before (0 h) and at 3, 6, 12, and 24 h after acute seizures in 31 patients during inpatient video-EEG monitoring. The patients were categorized into the TLE and the XTLE group based on video-EEG recordings and MRI findings.Fifteen patients had TLE and 16 XTLE. Index seizures were mainly complex partial seizures (n = 21). In TLE mean ± S.D. values for NSE levels (μg/L) were 8.36 ± 2.64 (0 h), 11.35 ± 3.84 (3 h), 13.48 ± 4.49 (6 h), 12.95 ± 5.46 (12 h) and 10.33 ± 3.13 (24 h) (p = 0.006, ANOVA). In XTLE the changes were not significant (p = 0.3). There was less increase in the levels of S-100 in TLE (p = 0.05) and no significant change in XTLE (p = 0.4).The levels of markers of neuronal damage were increased in patients with TLE, not only after tonic-clonic but also after complex partial seizures. These data suggest that TLE may be associated with brain damage.