[P1-87] Spinal fluid cytokine levels and SPECT findings in complex febrile seizures.
[Introduction]
Complex febrile seizures (cFS) are indistinguishable from acute encephalopathy (AE) during the acute phase. We reported that CSF IL-6 levels may be predictors of AE, and that single-photon emission computed tomography (SPECT) may not be suitable for initial diagnosis of AE (Neuropediatrics 2016). In this study, we assessed the CSF cytokine levels and SPECT findings in cFS.
[Method]
Twenty-four Japanese patients with cFS (17 male and 7 female patients; age, 1-6.7 years) were enrolled in this study. The diagnoses of cFS were made on the basis of Japanese febrile seizures guideline 2016. Tc99mECD-SPECT was performed in 21 cases. CSF cytokine levels were measured using the Bio-Plex multiplex cytokine assay in 17 cases, and compared with the levels in thirty patients with AE. CSF samples were obtained after the patients provided informed consent. Statistically significant differences were assessed using Mann–Whitney U test.
[Results]
Areas of hypoperfusion were detected by SPECT in 18 of the 21 patients; these areas were frontal-parietal (11), frontal-temporal (7), temporal lobe (1), occipital lobe (5), left hemisphere (3), cerebral cortex (1), and cerebellum (1); overlapping with other areas. On comparison with patients showing AE, the CSF levels of IL-6, IL-1β, TNF-α, and IL-10 were significantly lower and the levels of IL-17 were significantly higher in cFS.
[Conclusions]
Patients with cFS frequently exhibit abnormal SPECT findings, and initial diagnosis of AE by SPECT is problematic. CSF IL-17 levels may also be a valid predictor for discrimination of cFS and AE.
Complex febrile seizures (cFS) are indistinguishable from acute encephalopathy (AE) during the acute phase. We reported that CSF IL-6 levels may be predictors of AE, and that single-photon emission computed tomography (SPECT) may not be suitable for initial diagnosis of AE (Neuropediatrics 2016). In this study, we assessed the CSF cytokine levels and SPECT findings in cFS.
[Method]
Twenty-four Japanese patients with cFS (17 male and 7 female patients; age, 1-6.7 years) were enrolled in this study. The diagnoses of cFS were made on the basis of Japanese febrile seizures guideline 2016. Tc99mECD-SPECT was performed in 21 cases. CSF cytokine levels were measured using the Bio-Plex multiplex cytokine assay in 17 cases, and compared with the levels in thirty patients with AE. CSF samples were obtained after the patients provided informed consent. Statistically significant differences were assessed using Mann–Whitney U test.
[Results]
Areas of hypoperfusion were detected by SPECT in 18 of the 21 patients; these areas were frontal-parietal (11), frontal-temporal (7), temporal lobe (1), occipital lobe (5), left hemisphere (3), cerebral cortex (1), and cerebellum (1); overlapping with other areas. On comparison with patients showing AE, the CSF levels of IL-6, IL-1β, TNF-α, and IL-10 were significantly lower and the levels of IL-17 were significantly higher in cFS.
[Conclusions]
Patients with cFS frequently exhibit abnormal SPECT findings, and initial diagnosis of AE by SPECT is problematic. CSF IL-17 levels may also be a valid predictor for discrimination of cFS and AE.