Tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-6 in cerebrospinal fluid from children with prolonged febrile seizures. Comparison with acute encephalitis/encephalopathy.

We investigated the levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-1 alpha (IL-1 beta), and IL-6 as proinflammatory cytokines in CSF to facilitate differentiation between acute encephalitis/encephalopathy and prolonged febrile seizures. We studied 20 children with prolonged febrile seizures and 23 with acute encephalitis/encephalopathy, including 8 with an acellular CSF. TNF-alpha, IL-1 beta, and IL-6 in CSF were measured by ELISA. We found that TNF-alpha, IL-1 beta, and IL-6 were undetectable in CSF of all children with prolonged febrile seizures and control subjects but that the concentrations of TNF-alpha was elevated in 11, of IL-1 alpha in 6, and of IL-6 in 17 of 23 children with acute encephalitis/encephalopathy. Twenty-two of 23 children with acute encephalitis/encephalopathy had elevated concentrations of one or more cytokine. Elevated concentrations of the CSF proinflammatory cytokines, TNF-alpha, IL-1 beta, and IL-6, indicate acute encephalitis/encephalopathy rather than febrile seizures.