Seizures, Focal Clinical Trial
Official title:
Effect of Carbamazepine and Oxcarbazepine on Serum Neuron-specific Enolase and S100B in Focal Seizures
The present study has been planned to assess the level of serum neuron-specific enolase (NSE) in focal seizures and its changes after antiepileptic therapy.
Epileptic seizures can cause neuronal cell death, enhanced neurogenesis, axonal sprouting,
dendritic changes, and reactive gliosis. Histopathological analyses have suggested that the
initial insult and recurrent seizures contribute to the neuronal damage. Activation of mesial
temporal structures is more likely to cause damage than that of other areas of brain;
therefore, one of the consequences of prolonged seizures is selective neuronal loss in the
hippocampus. The excitotoxic damage is considered the most important mechanism of injury but
there is also evidence that programmed cell death contributes to neuronal damage.
Various biomarkers of brain damage have been studied in the context of epilepsy and brain
damage but most widely investigated biochemical biomarker is neuron-specific enolase (NSE).
NSE is γγ-isoenzyme of enolase involved in glycolysis pathway. NSE originates predominantly
from the cytoplasm of neurons and neuroendocrine cells. Neuronal damage and impairment of
blood brain barrier integrity can be detected by the release of NSE into cerebrospinal fluid
(CSF) and eventually into blood. NSE is therefore regarded as a marker of neuronal damage and
prognosis in various disorders associated with cell damage in the central or peripheral
nervous system.
CSF and serum NSE levels obtained within first 48 hours were found to be elevated and
correlated well with the duration of epilepsy and outcome of patients. Some studies have
shown elevated NSE levels in temporal lobe epilepsy, after single tonic-clonic seizures, and
status epilepticus. Literature review reveals that there is lack of data on serum NSE in
focal seizures and there is no study on the effect of antiepileptic drugs on the level of
serum NSE. So the present study has been planned to assess the level of serum NSE in focal
seizures and its changes after antiepileptic therapy.
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