ACETYLCHOLINE AND NEURONAL ACTIVITY: II. ACETYLCHOLINE AND CHOLINESTERASE ACTIVITY IN THE CEREBROSPINAL FLUIDS OF PATIENTS WITH EPILEPSY

Abstract

Cerebrospinal fluid acetylcholine assays were done on 119 samples from 109 neurological and neurosurgical patients. Of these 56 were epileptic and 53 non-epileptic patients. Acetylcholine was present in the cerebrospinal fluids of eight (15%) of nonepileptics, six of whom were cases of craniocerebral trauma (previously shown to give positive assays). In contrast 44 (77%) of epileptic patients had positive cerebrospinal fluid acetylcholine assays in amounts of 0.02 to 5.0 μgm. % acetylcholine (average 1.0 μgm. %). The presence of acetylcholine in cerebrospinal fluids of epileptics was apparently related to the frequency of seizures, the occurrence of seizures, and the extent of electroencephalographic abnormalities in these patients. Factors of cerebrospinal fluid cholinesterase values, medications, thresholds of assay methods, and types of epilepsy (with the exception of focal seizures due to intracranial tumor) seemed to be of no significance for these results. This study does not indicate whether the acetylcholine recovered in epileptic cases was directly related to the occurrence of seizures or merely a coincidental finding. The presence of acetylcholine in cerebrospinal fluids in association with epileptic seizures is considered to be significant in the light of previous studies discussed.