Creatine phosphokinase content in cerebrospinal fluid

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MOST of the many recent studies on enzymatic determinations of the cerebrospinal fluid (CSF) of patients with neurologic disease have been centered on the variations of creatine phosphokinase (CPK) values in regard to acute disorders of the central nervous system. The results often have been conflicting, contradictory, or negative.1 There are some well-documented cases2–4 of significant increases of CPK content after extensive infarctions of the central nervous system. Little is known about such values in patients who have chronic neurologic diseases. Since CPK is an abundant enzyme in the central nervous system, and the indications are that the content increases when the central nervous system suffers injury,4–7 albeit the evidence has not yet been correlated with the various nosologic entities, we planned to determine the values of CPK in CSF specimens of randomly selected patients, and to compare the pathologic increases with the clinical evidence of disease for a possible correlation.

Materials and methods

One hundred patients, chosen at random, with various neurologic diseases were studied. The CPK values were determined in specimens of CSF of all the patients, and also for most of them, those in sera. The specimens were obtained by lumbar puncture, and the standard tests were applied—determination of cells, protein, globulins, Wassermann—and protein electrophoresis when indicated.

The CPK values were determined by the automated fluorometric ninhydrin reaction.8, 9 In our laboratory, the normal range of CPK values in serum is 0 to 13.5 sigma units (1 sigma unit = μM/ml creatine × 20).



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