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Reply from the Authors: We welcome the comments of Schmitt and Bandtlow. In review, we reported the first prospective study of serum neuron-specific enolase (s-NSE), a marker of acute neuronal injury after stroke and anoxia, in status epilepticus (SE). Our specific aim was to determine if s-NSE is elevated after SE, and if so, was it correlated with outcome and duration. The results of this pilot study were highly significant. s-NSE was elevated even in those without an acute neurologic insult (remote symptomatic SE). Further, for the 19 patients s-NSE was highly correlated with the 1-week Glasgow Outcome Score (GOS) and the duration of SE.
Schmitt and Bandtlow assert that CSF NSE is the more promising marker of brain injury, and cite their own unpublished data. They suggest that s-NSE is more variable than CSF NSE, but multiple studies in animals and humans have shown s-NSE to be a highly specific marker in stroke and anoxic-coma. [2-4] Roine et al. [3] have pointed out "... the relatively high specificity of the serum test and the good correlation between serum and CSF levels of NSE suggest that it may be useful as a routinely available substitute for CSF measurements.'' We have collected CSF and serum samples in 10 patients in SE, and found CSF NSE to be …
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