The significance of elevated CSF lactate

Abstract

The final diagnosis of 158 patients who had a cerebrospinal fluid (CSF) lactate concentration greater than 2 mmol/l was ascertained. The conditions included seizures, inflammatory changes, and proven metabolic disorders. For the diagnosis of congenital lactic acidoses, CSF lactate should ideally be measured in a seizure free patient after any acute illness.

Figure 1

CSF lactate concentrations in different diagnostic groups. Open symbols: sample in acute illness. Closed symbols: sample in chronic illness. 1: Respiratory chain disorders; 2: pyruvate dehydrogenase deficiency; 3: other metabolic disorders (see text); 4: infection/inflammation; 5: ischaemia; 6: malignancy; 7: seizures; 8: multiple aetiology; 9: unknown.