Neuron-Specific Enolase in Comatose Children

Nara, Takahiro; Nozaki, Hideki; Nakae, Youichiro; Arai, Takashi; Ohashi, Toya

doi:10.1001/archpedi.1988.02150020075032

Cited by 11 publications

(6 citation statements)

References 6 publications

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“…[5][6][7] Previous studies in adults and children reported a level of <10 ng/mL as normal. [7][8][9][10][11][12] Skogseid et al and Yamazaki et al noted higher NSE levels in a larger proportion of patients with severe head trauma and a GCS < 9, compared with those with less severe injury. 10,12 However, none of these studies compared NSE levels directly with the presence of ICL.…”

Section: Discussionmentioning

confidence: 99%

“…Over the past decade several reports have identified neuron-specific enolase (NSE) as a reliable marker of neuronal injury in humans. [5][6][7] Several studies in adult patients have shown NSE levels to be predictive of injury severity, the extent of neuronal injury, and the outcome for patients with head injury. [8][9][10][11][12] Given the lack of reliable clinical predictors of intracranial injury, the addition of NSE serum levels may allow a more precise assessment of the risk of intracranial pathology, and the likely outcome.…”

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confidence: 99%

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Serum Neuron‐specific Enolase as a Predictor of Intracranial Lesions in Children with Head Trauma: A Pilot Study

Fridriksson

Kini

Walsh‐Kelly

et al. 2000

Academic Emergency Medicine

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Abstract. Objective: To determine the reliability of serum neuronspecific enolase (NSE) levels in predicting intracranial lesions (ICL) in children with blunt head trauma (HT). Methods: A prospective pilot study was conducted of patients 0 to 18 years of age presenting to a children's hospital emergency department (ED) between December 1997 and October 1998. Children presenting within 24 hours of injury who required head computed tomography (CT) were eligible. Blood samples were obtained to measure serum NSE level. Data collected included patient demographics, historical information, Glasgow Coma Scale score (GCS), physical examination, head CT results, and outcome. Patients were assigned to one of two groups based on the head CT results (PICL; presence of intracranial lesion, or NICL; no intracranial lesion). Data were analyzed using Student's t-test and chisquare. The 95% confidence interval (95% CI) was calculated when appropriate. A receiver operating characteristic curve was constructed to determine the NSE level that yielded the highest sensitivity and specificity for predicting ICL. Results: Fifty patients were enrolled; 22 (45%) had abnormal head CT. No difference in demographics or mechanism of injury was observed between those with abnormal or normal CT scans. The mean GCS level was 11.9 Ϯ 4.2 for PICL and 13.9 Ϯ 2.6 for NICL (p = 0.045; 95% CI = Ϫ0.05 to Ϫ3.9). The mean NSE level was 26.7 Ϯ 21.4 for PICL and 17.7 Ϯ 7.8 for NICL (p = 0.048; 95% CI = 0.1 to 17.9). An NSE level Ն15.3 ng/mL yielded a sensitivity of 77%, a specificity of 52%, and a negative predictive value of 74%. Conclusions: These results suggest that serum NSE may be a useful screening tool for predicting ICL in children with blunt head trauma. However, the NSE alone was neither sensitive nor specific in predicting all patients with ICL.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Serum Neuron‐specific Enolase as a Predictor of Intracranial Lesions in Children with Head Trauma: A Pilot Study

Fridriksson

Kini

Walsh‐Kelly

et al. 2000

Academic Emergency Medicine

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“…Elevated NSE levels have been reported in the cerebrospinal fluid (CSF) of patients with cerebral infarction [2], head injury [3], brain tumours [4] and infectious diseases of the brain [5]. Serum and CSF NSE levels have been measured sequentially in patients with Reye's syndrome, acute encephalitis and acute encephalopathy [6]. Correspondence Most studies relating neuronal damage to NSE levels have looked at CSF levels.…”

Section: Introductionmentioning

confidence: 99%

Serum neurone specific enolase (NSE) levels as an indicator of neuronal damage in patients with cerebral infarction

Cunningham

Young

Winder

et al. 1991

Eur J Clin Investigation

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A radioimmunoassay has been developed and used to measure serum neurone specific enolase (NSE) concentrations in 24 patients, following cerebral infarction. A significant correlation between cerebral infarct volume and maximum serum NSE concentration was observed (P = 0.047). Serum NSE was also assayed at times 24, 48, 72 and 96 h post ictus. At 72 h a significant correlation existed between serum NSE levels and infarct volume (P = 0.012), and levels appeared to be approaching statistical significance at 48 h (P = 0.067). No correlation existed at 24 and 96 h. In addition serum concentrations of NSE were compared to clinical outcome as determined by the Glasgow Outcome Score. Using the Mann-Whitney U test, there was no significant difference in maximum NSE level between patients graded 1-3 on the Glasgow Outcome Score and those graded 4 and 5. However, further studies are required on a larger population to more completely assess this. NSE may prove to be a useful marker of neuronal damage in the study of stroke, with particular application in the assessment of treatment.

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“…were initially (after 15 minutes) elevated up to 10.0 m g/l and showed a rapid decline to 1.14 m g/l 6 hours and to 0.47 m g/l 12 hours after injury. The following serum levels 24 hours to 5 days after injury were all below 0.5 m g/l.…”

Section: S-100 Protein Serum Levelsmentioning

confidence: 95%

Case study: Rapid evaluation of S-100 serum levels. Case report and comparison to previous results

Rothoerl

Woertgen²,

Holzschuh³

et al. 1999

Brain Injury

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The aim of this case report is to describe the time course of S-100 serum levels of a patient, after severe head injury, whose blood sample could be drawn very soon after injury. The results were compared to a group of patients in which a correlation between S-100 serum levels and outcome after traumatic brain injury could be demonstrated. Blood samples were taken on admission (mean 2.3 hours), 6, 12 and 24 hours after trauma and then every 24 hours up until and including the fifth day. The outcome was estimated on discharge using the Glasgow Outcome Scale. The S-100 serum level of the patient described in the case report with a favourable outcome had initially risen to 10.0 micrograms/l and showed a rapid decline. In the previous group, patients with unfavourable outcome had a S-100 serum level of 7 micrograms/l mean concerning the first probe (after 2.3 hours mean) compared to 1.5 micrograms/l mean (after 2.23 hours mean) in patients with favourable outcome (p < 0.05). In comparison to the literature, there seems to be differences regarding the enzyme liberation in stroke and head injury. Therefore, S-100 serum levels need to be interpreted with regard to collection time and underlying pathology.

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Neuron-Specific Enolase in Comatose Children

Cited by 11 publications

References 6 publications

Serum Neuron‐specific Enolase as a Predictor of Intracranial Lesions in Children with Head Trauma: A Pilot Study

Serum Neuron‐specific Enolase as a Predictor of Intracranial Lesions in Children with Head Trauma: A Pilot Study

Serum neurone specific enolase (NSE) levels as an indicator of neuronal damage in patients with cerebral infarction

Case study: Rapid evaluation of S-100 serum levels. Case report and comparison to previous results

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