Prolonged
febrile seizures may be followed by acute
encephalopathy with neurological sequelae. To investigate the function of the blood-brain-barrier (BBB) in acute
encephalopathy following prolonged
febrile seizures with neurological sequelae (AEPFS), the concentrations of serum
matrix metalloproteinase-9 (MMP-9) and tissue inhibitors of
metalloproteinases 1 (TIMP-1) were measured by ELISA in 10 children with AEPFS, 16 with prolonged
febrile seizures without
encephalopathy (PFS), 20 with simple
febrile seizures (SFS), 23 with convulsive
status epilepticus (CSE), and 18 with
West syndrome. Serum MMP-9 levels in AEPFS and PFS patients were significantly higher than those in SPS and
West syndrome patients and in controls, and those in CSE patients were significantly higher than in controls. Serum
TIMP-1 levels in AEPFS patients were significantly lower than those in PFS, SFS, CSE and
West syndrome patients and in controls. Serum MMP-9 levels and
MMP-9/TIMP-1 ratios in AEPFS patients with motor
paralysis were significantly higher than for those without motor
paralysis. Our results suggest that prolonged
seizures are related to high serum MMP-9 levels, and that an increased
MMP-9/TIMP-1 ratio in AEPFS might induce dysfunction of the BBB. Furthermore, an imbalance of serum MMP-9 and
TIMP-1 levels in patients with AEPFS may be associated with severe neurological sequelae.