Background: Brain specific proteins (BSP) are proteins more or less exclusively found in the central nervous system. BSP levels in the cerebrospinal fluid (CSF) have previously been used to estimate the degree of brain damage in a variety of diseases.

Aim: To analyse the levels of the BSP neuron specific enolase (NSE), glial fibrillary acidic protein (GFAP), neurofilament protein (NFp) and glial S-100 in the cerebrospinal fluid after asphyxia. Patients: Twenty two term infants with birth asphyxia and 9 term control infants.

Methods: CSF was sampled between 12 and 72 hours of age. All four proteins were significantly increased in the CSF of asphyxiated infants when compared to controls. Subanalysis of the asphyxiated group showed that the most pronounced increases were found in infants with the highest risk of future brain damage as judged from stage of encephalopathy, electrophysiology and neuroimaging in the neonatal period.

Conclusions: All BSP are significantly increased in the CSF of asphyxiated infants during the first days of life. The increase seems to be most pronounced for the intermediary filaments. BSP may help in the prognostic evaluation following birth asphyxia, especially in ventilated and sedated patients. Table

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