SERUM CORTISOL AND CEREBROSPINAL-FLUID BETA-ENDORPHINS IN STATUS EPILEPTICUS - THEIR POSSIBLE RELATION TO PROGNOSIS

Objective.-To determine if blood cortisol and cerebrospinal fluid beta -endorphin levels correlate with prognosis following status epilepticu s. Design.-Twenty-seven adult patients with status epilepticus had blo od cortisol and cerebrospinal fluid beta-endorphin levels measured wit hin 12 hours after the cessation of clinical seizures. Setting.-Patien ts with status epilepticus as well as patients with non-status epilept icus seizures came from the Comprehensive Epilepsy Program at the Medi cal College of Virginia, Richmond. Patients.-Twenty-seven patients wit h status epilepticus. Control patients for the cortisol study were pat ients who had acute seizures who did not meet the criteria for status epilepticus. The cerebrospinal fluid control subjects were patients wi thout neurologic symptoms undergoing spinal anesthesia. Outcome Measur es.-The clinical status of the patients 1 week after status epilepticu s as well as the Glascow Outcome Score and the Glascow Coma Score 1 we ek after status epilepticus. Results.-The difference in blood cortisol levels in patients with status epilepticus with poor prognosis was si gnificantly different from both patients with non-status epilepticus s eizures (P<.001) and patients with status epilepticus with good progno sis (P<.01). Cerebrospinal fluid beta-endorphin levels were elevated i n patients with status epilepticus patients vs control subjects (P<.05 ), but no significant difference was noted between the patients with s tatus epilepticus with good and poor prognosis. Conclusions.-Serum cor tisol levels may provide a useful predictive indicator of prognosis in status epilepticus and cortisol level elevation may play a role in th e pathophysiologic condition of status epilepticus.