The Cerebrospinal Fluid in `Essential' Epilepsy

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Abstract
The spinal fluid from a variable number of individuals suffering from recurrent convulsions (essential epilepsy), for which no organic lesion of the nervous system was demonstrable by clinical means, was submitted to a variety of tests. The pressure of the fluid was less than 70 mm. (of fluid) in 2%, between 70 and 180 mm. ("normal") in 81%, between 180 and 200 mm. in 8%, between 200 and 300 mm. in 9%. The protein content of the fluid was below 45 mgm. per 100 cc. ("normal") in 89.5%, between 46 and 85 mgm. in 102% and between 85 and 200 mgm. in 0.3%. The number of white blood cells per cu. mm. of fluid varied between 0 and 21 cells. Only 1 patient (0.136%) had more than 10 cells, only 30 (4%) had more than 5. The amount of glucose in the fluid was between 38 and 80 mgm. per 100 cc. in 85%, between 80 and 100 mgm. in 11%, between 100 and 167 mgm. in 4%. The amount of chloride measured as NaCl was between 658 and 700 mgm. per 100 cc. in 5%, between 700 and 760 mgm. in 93%, between 760 and 794 mgm. in 2%. The colloidal gold reaction was considered "normal" in all cases (no reading greater than 2). The Ca content of the fluid varied between 4.1 mgm. and 5.8 mgm. per 100 cc. of fluid with an average of 5 mgm. The non-protein N (measured in only 10 cases) varied between 11 and 26 with an average of 17 mgm. per 100 cc. Repeated examination in a few cases over a period of years usually demonstrated a return to normal values (in the various tests) in those few cases in which abnormal values had first been obtained. The authors conclude that "any marked abnormality in pressure or the contents of the fluid makes the diagnosis of ''essential'' epilepsy hazardous.".

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