Table 1.
Inflammatory and metabolic testing in CSF of patients with nodding syndrome
| Case 1 | Case 2 | Case 3 | |
|---|---|---|---|
| White blood cell count | 3 | 3 | 1 |
| Cytology | Normal | Rare foamy macrophages | Normal |
| Red blood cell count | 0 | 1 | 1 |
| Protein (mg/dl) | 21 | 19 | 15 |
| Glucose (mg/dl) | 63 | 47 | 50 (serum 71) |
| IgG index | Normal | Normal | Normal |
| Albumin quotient | Normal | Low | Low |
| Oligoclonal bands | Negative | Positive | Partially identical in CSF and serum |
| Lactate | Normal | Normal | Normal |
| Amino acid profile | ↑alanine | No diagnostic pattern | No diagnostic pattern |
| 5-Hydroxyindoleacetic acid (ref 67–189 nmol/l) | 35 ↓ | 79 | 95 |
| Homovanillic acid (ref 167–563 nmol/l) | 79 ↓ ↓ | 124 ↓ | 273 |
| 3-O-Methyldopa (ref <100 nmol/l) | 8 | 13 | 11 |
| Neopterin (ref 8–33 nmol/l) | 19 | 15 | 23 |
| Tetrahydrobiopterin (ref 9–32 nmol/l) | 14 | 19 | 18 |
| 5-Methyltetrahydrofolate (ref 40–120 nmol/l) | 49 | 50 | 47 |
| Pyridoxal 5-phosphate (ref 10–37 nmol/l) | 19 | 16 | 18 |
| Biomarkers for folinic acid-/pyridoxine-responsive seizures (Antiquitin, ALDH7A1) | Not detected | Not detected | Not detected |