Postictal pleocytosis

Abstract

Six patients showed a transient and otherwise unexplained cerebrospinal fluid (CSF) pleocytosis following a flurry of generalized convulsions. Each had an obvious cause for repeated seizures. No evidence was found for an infectious, inflammatory, neoplastic, or other cause for the pleocytosis. All CSF specimens were clear and colorless, under normal pressure, and bacteriologically sterile. The maximal leukocyte count ranged from 9 to 80 per cubic millimeter and reached a maximum on the day after cessation of convulsions. No specimen contained more than 650 erythrocytes. Two patients initially had a mildly increased CSF protein; glucose values were unremarkable. We propose that the pleocytosis in these patients was a result of frequently repeated generalized convulsions. The mechanism of postictal pleocytosis is uncertain. It may result from transient breakdown of the blood-brain barrier, which has been demonstrated after seizures in experimental animals. Although infectious causes must first be considered and rigorously searched for, it appears that seizures alone may cause a transient CSF pleocytosis.

Normal cerebrospinal fluid values in full-term gestation and premature neonates

“…It had also been reported that patients who are first seen with seizures have a CSF pleocytosis as the result of the seizure itself 24 . Besides that, patients with seizures do form a large proportion of those The CSF profile, like any other laboratory determination, should be evaluated within the clinical context of the individual case.…”

How to Interpret a CSF—The Art and the Science

“…A number of studies have reported postictal CSF pleocytosis in patients with epilepsy following an episode of status epilepticus (Aminoff and Simon, 1980;Woody et al, 1988;Barry and Hauser, 1994;Rider et al, 1995) or prolonged seizure (Schmidley and Simon, 1981;Edwards et al, 1983;Prokesch et al, 1983;Devinsky et al, 1988;Rider et al, 1995). However, in most of these studies, observed changes were minimal.…”

“…Whether convulsions cause changes in the CSF is frequently debated as there is inconsistent information about this in the literature (Aminoff and Simon, 1980;Schmidley and Simon, 1981;Edwards et al, 1983;Simon, 1985;Thompson and Salinsky, 1988;Woody et al, 1988). The reported frequency of seizure-induced CSF abnormalities has been estimated to be as high as 30% (Prokesch et al, 1983).…”

Estudo das concentrações de proteína C-reativa sérica e liquórica em cães com epilepsia idiopática

“…Em medicina humana, as convulsões têm sido associadas a alterações como pleocitose e aumento dos níveis de proteínas (AMINOFFE; SIMON, 1980;SIMON, 1981;EDWARDS et al, 1983, PROKESCH et al, 1983, entretanto, a ocorrência dessas anormalidades na análise de LCR após um EC são muito variáveis, tendo sido observadas em aproximadamente 30% dos casos (EDWARDS et al, 1983;PROKESCH et al, 1983).…”

“…Os mecanismos pelos quais as convulsões podem influenciar a composição fisiológica do LCR não são claros, porém acredita-se que ocorra alteração na barreira hematencefálica e liberação de substâncias quimiotáticas para o LCR durante as crises epilépticas (SCHMIDLEY; SIMON, 1981;EDWARDS et al, 1983).…”