The Axonal Damage Marker Tau Protein in the Cerebrospinal Fluid Is Increased in Patients With Acute Encephalopathy With Biphasic Seizures and Late Reduced Diffusion

Brain Dev. 2010 Jun;32(6):435-9. doi: 10.1016/j.braindev.2009.07.004. Epub 2009 Aug 12.


Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a recently clinicoradiologically-established encephalopathy syndrome. In the present study, we examined the levels of cerebrospinal fluid (CSF) tau protein, a marker of axonal damage, in 11 patients with AESD. CSF tau levels were normal on day 1 and increased from day 3 of the disease between the initial and the secondary seizures. Magnetic resonance imaging (MRI) reveals reduced diffusion in the subcortical white matter during days 3-7. Two patients showed elevated tau protein prior to the diffusion abnormality of subcortical white matter on MRI. Levels of CSF neuron specific enolase (NSE), a neuronal marker, were elevated in only two out of seven patients with AESD, and CSF tau levels were also increased in these patients. Our results indicated that tau protein is a more sensitive marker than NSE and axonal damage causes the conspicuous MRI findings in AESD patients. A therapeutic strategy for axonal protection should be developed to prevent severe neurological impairment of AESD patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Age Factors
  • Axons
  • Brain / pathology*
  • Brain Diseases / cerebrospinal fluid*
  • Brain Diseases / pathology
  • Child
  • Child, Preschool
  • Diffusion
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Humans
  • Infant
  • Kinetics
  • Magnetic Resonance Imaging
  • Male
  • Nerve Fibers, Myelinated / pathology
  • Phosphopyruvate Hydratase / cerebrospinal fluid
  • Seizures / cerebrospinal fluid*
  • Seizures / pathology
  • Time Factors
  • tau Proteins / cerebrospinal fluid*


  • MAPT protein, human
  • tau Proteins
  • Phosphopyruvate Hydratase