In the diagnostic workup of epileptic seizures, analyzing cerebrospinal fluid (CSF) is critical to rule out autoimmunity or infections as an underlying cause, so researchers described postictal changes in CSF to distinguish between negligible and etiopathologically pertinent changes in CSF profile.
The study included 247 newly diagnosed patients with epileptic seizures and analysis of CSF during a diagnostic workup. They excluded patients with possible or definitive autoimmune or infectious encephalitis.
According to this retrospective analysis, higher concentrations of lactate and total protein as well as blood-brain barrier dysfunction are often seen after epileptic seizures vs mild pleocytosis and Ig synthesis. They suggested semiology of seizures could affect CSF profiles. After motor onset seizures, the highest lactate concentrations were found. These results can help physicians avoid over-interpretation of minor changes in CSF. Still, excluding other causes should always be carefully considered in view of other clinical characteristics.