DOES GLUTAMATE MEDIATE BRAIN-DAMAGE IN ACUTE ENCEPHALITIS

CEREBROSPINAL fluid (CSF) amino acid neurotransmitter concentrations i n 23 patients with acute encephalitis were compared with those in pati ents with acute brain infarction, multiple sclerosis and controls. The concentration of glutamate was significantly higher in encephalitis ( 5.2+/-6.71 mu mol/l) and stroke patients (9.6 +/- 14.2 mu mol/l) than in MS patients (1.6 +/- 0.9 mu mol/l) and controls (1.7 +/- 0.8 mu mol /l; p < 0.001). The concentration of glycine was significantly higher in encephalitis (11.0 +/- 4.7 mu mol/l) than in stroke (7.6 +/- 3.2 mu mol/l) and MS patients (6.3 +/- 2.1 mu mol/l) or controls (5.6 +/- 1. 8 mu mol/l; p < 0.002). Taurine levels were significantly lower in enc ephalitis patients than in the other groups (p = 0.04). The correlatio n of high glutamate levels with poor outcome was almost significant (K endall tau 0.63, p = 0.06). Our observations suggest that exicitotoxic neurotransmission may play an important role in the series of events that lead to neuronal damage in encephalitis.