DIAGNOSTIC INFORMATIVENESS OF THE STUDY OF NEURON-SPECIFIC ENOLASE IN THE BLOOD OF SURGICAL PATIENTS WITH TRAUMATIC NEUROPATHY OF THE TRIGEMINAL NERVE
DOI:
https://doi.org/10.35220/2078-8916-2023-47-1.18Keywords:
neuron-specific enolase (NSE), laboratory diagnosis, trigeminal nerve, traumatic neuropathy, mild brain injury, zygomatic fracture.Abstract
According to the professional literature, the determination of neuron-specific enolase (NSE) in cerebrospinal fluid and/or blood serum allows the assessment of the degree of mechanical and/or ischemic neuronal damage. Taking into account the above, we aimed to establish the diagnostic informativeness of the study of the content of NSE in the blood as a marker of damage to the peripheral branches of the trigeminal nerve in surgical patients with a combined trauma of the middle face. Clinical observations were carried out on 50 patients with a combined trauma of the middle face – mild traumatic brain injury (TBI) -concussion or a slight contusion of the brain and multiple fractures of the zygomatic bones and arches, which were accompanied by traumatic neuropathy of the second branch of the trigeminal nerve (infraorbital, zygomatic ) of varying severity. Patients were divided into two clinical groups. The first clinical group included 31 patients with brain concussion, among them 14 patients were diagnosed with mild neuropathy (neuropraxia) of the infraorbital and zygomatic nerves, and 17 with moderate neuropathy of these nerves (axonotmesis). The second clinical group included 19 patients with mild concussion. They had clinical and functional signs of neuropathy of the branches of the maxillary nerve of medium severity. The degree of nerve damage and the reduction of the clinical and functional symptoms of neuropathy were determined instrumentally by means of electroodontometry of the canines of the mandible and measurement of the electrical potentials of the facial skin on the side of the zygomatic bone damage, and the content of NSE was determined in the blood serum. The study was conducted during hospitalization, on the 7th and 14th days of the postoperative period. It has been established that the determination of NSE in the blood of surgical patients with traumatic neuropathy of the trigeminal nerve has diagnostic informativeness (diagnostic sensitivity and specificity) with an average degree of damage, when the concentration of this neuronal enzyme increases excessively. A mild brain injury (concussion) does not affect on these indicators. On the background of the clinical manifestation of a mild concussion and its neurological complications (arachnoiditis), the specificity, diagnostic efficiency and prognostic significance of the NSE study as a "sensitive" marker for assessing the nature of damage to the peripheral branches of the trigeminal nerve decreases.
References
Григорьев Е.В., Гришанова Т.Г., Будаев А.В., Дербенева О.А. Нейронспецифические белки – маркеры энцефалопатии при тяжелой сочетанной травме. Медицина невідкладних станів. 2010, № 2(27). URL: http:// www.mif-ua.com/archive/issue-12820/.
Joseph B., Pandit V., Zangbar B. Secondary brain injury in trauma patients: the effects of remote ischemic conditioning // J Trauma Acute Care Surg. 2015. Vol. 78, № 4. P. 698–703.
Pandey A., Shrivastava A.K., Saxena K. Neuron Specific Enolase and C–reactive Protein levels in stroke and its subtypes: correlation with degree of disability // Neurochem Res. 2014. Vol. 39, № 8. P. 1426–1432.
Ведунова М.В., Терентьева К.А., Щелчкова Н.А. Диагностическое значения определения концентрации нейротрофических факторов и нейронспецифической енолазы в крови новорожденных с нарушениями ЦНС // Современные технологии в медицине. 2015. Т. 7, № 2. С. 25–32.
Сорокіна О.Ю., Буряк Т.О. Нейрон-специфічна енолаза як маркер пошкодження нервової тканини у хворих з тяжкою термічною травмою // Біль, знеболення та інтенсивна терапія. 2015. № 4. С. 76–82.
Mercier E., Zarychanski R., Archambault P., Lamontagne F. Predictive value of neuron-specific enolase for prognosis in patients with moderate or severe traumatic brain injury: a systematic review and meta-analysis // Can Med Ass J Open. 2016. Vol. 3, № 4. P. 371–382.
Gelderblom M., Daehn T., Schattling B. Plasma levels of neuron specific enolase quantify the extent of neuronal injury in murine models of ischemic stroke and multiple sclerosis // Neurobiol dis. 2013. № 59. P. 177–182.
Pypa L.V., Svistilnik R.V., Moskovko G.S. Neuron specific enolase as a possible indocator of neuron damage in children with acute meningitis // Запорожский медицинский журнал. 2018. Т. 20, № 3 С. 354–358.
Hirokazu H. Production of the neuron-specific enolase in astrocytes, but not in neurons, under the neuronal inflammation. Seikagaku. 2017 Apr.; 89(2): 241-3.
Камилов Х.М., Касимова М.С., Хамраева Г.Х. Cпецифический маркер нейродегенерации при диагностике оптических невритов // Офтальмология. 2015. Т. 12, № 2. С. 25–30.
Seddon HJ. A Classification of Nerve Injuries. Br Med J. 1942 Aug 29;2(4260):237-9.
Бернадский Ю.И. Травматология и восстановительная хирургия черепночелюстно-лицевой области: Учеб. пособие для студентов мед. вузов, курсантов, врачей фак. (акад.) последиплом. образования врачей, практ. Врачей – хирургов, стоматологов, травматологов / Ю.И. Бернадский, 2003. – 444 с.
Сирак С.В. Клинико-анатомическое обоснование лечения и профилактики травм нижнеальвеолярного нерва, вызванных выведением пломбировочного материала в нижнечелюстной канал [дисертація]. Москва: Центр. науч.-исслед. ин-т стомат; 2006. 287 с.
Королюк И.П. Медицинская информатика: учебник. 2 изд., перераб. и доп. Самара: Офорт; 2012. 244 с.
Погоріла А.В., Ходаківський О.А., Шінкарук- Диковицька М.М. Динаміка активності нейрон-специфічної енолази та титрів білка s100 у сироватці крові хворих на ятрогенно компресійно-токсичне ураження нижнього альвеолярного нерву за різної лікувальної тактики. Вісник Вінницького національного медичного університету. 2018; 22 (1): 112 – 119.
Назаревич М.Р, Огоновський Р.З, Погранична Х.Р. Удосконалення діагностики та лікування сенсорних порушень середньої зони обличчя у хворих з ізольованими переломами дна очниці. Клінічна стоматологія. 2018;(3):60-9.
Baroni S., Rapisarda A., Gentili V., Burattini B., Moretti G., Sarlo F. CSF neuron-specific enolase as a biomarker of neurovascular conflict severity in drug-resistant trigeminal neuralgia: a prospective study in patients submitted to microvascular decompression. Neurol Sci. 2022 Dec 23. doi: 10.1007/s10072-022-06573-z.
Zhong Ch., Lin D., Liu Y., Wu Ch. A retrospective study of the correlation between herpes zoster neuralgia and the serum neuron-specific enolase level in the largest dermatological hospital in Zhejiang province, China. Front Immunol. 2022 Oct 6;13:972536.
Thelin E., Jeppsson E., Frostell A., Svensson M., Mondello S., Bellander M., Nelson W.D. Utility of neuronspecific enolase in traumatic brain injury; relations to S100B levels, outcome, and extracranial injury severity. Critical Care. 2016; 20:285.
Sun Y., Wang Sh., Gan Sh., Niu X., Yin B., Bai G. et al. Serum Neuron-Specific Enolase Levels Associated with Connectivity Alterations in Anterior Default Mode Network after Mild Traumatic Brain Injury. J Neurotrauma. 2021 Jun 1;38(11):1495-1505.
Mercier E., Tardif P-Al., Cameron P. A, Émond M., Moore L., Mitra B., Ouellet M.-Ch. et al. Prognostic value of neuron-specific enolase (NSE) for prediction of postconcussion symptoms following a mild traumatic brain injury: a systematic review. Brain Inj. 2018; 32(1):29-40.
