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In epilepsy, most studies have focused on Nf-L levels either in epileptic seizures or in status epilepticus. We sought to investigate the correlation between epileptic seizures of different duration and elevated Nf-L levels as a biomarker for neuroaxonal injury also considering methodological confounders in Nf-L measurement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In adult patients, Nf-L was investigated in serum and\/or cerebrospinal fluid (CSF) after a single epileptic seizure (51 patients), acute repetitive seizures (11 patients) or status epilepticus (20 patients) along with standard acute CSF parameters. In addition, ratios of Nf-L to age-adjusted reference intervals were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In both serum and CSF, absolute Nf-L levels were significantly increased after status epilepticus compared to patients who experienced a single seizure (serum:\u00a0\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001; CSF:\u00a0\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0008) or acute repetitive seizures (serum:\u00a0\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035 CSF:\u00a0\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045). Similarly, age-adjusted Nf-L ratios in serum were higher after status epilepticus (median\u2009=\u20091.68, interquartile range\u2009=\u20092.81) than after a single seizure (median\u2009=\u20090.67, interquartile range\u2009=\u20090.73;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039). Though ANOVA-testing indicated significant differences in CSF Nf-L ratios between the three groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040), pairwise post hoc testing was not significant. A moderate significant positive correlation was observed between the duration of status epilepticus and serum Nf-L concentrations (Pearson r\u2009=\u20090.48,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our data indicate that single and acute repetitive seizures likely do not cause significant neuronal injury as assessed by Nf-L concentrations in serum and CSF. In contrast, status epilepticus is accompanied by a duration-dependent increase in serum Nf-L, which presumably reflects seizure-associated cellular injury and underlines the need for rapid and consistent antiseizure treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-026-13780-7","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T15:12:50Z","timestamp":1775142770000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Neurofilament light-chain (Nf-L) as a biomarker in seizures and status epilepticus of varying duration"],"prefix":"10.1007","volume":"273","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8918-6715","authenticated-orcid":false,"given":"Sophie","family":"Schlabitz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8682-0215","authenticated-orcid":false,"given":"Jakob I.","family":"Doerrfuss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2414-0441","authenticated-orcid":false,"given":"Jonas M.","family":"Hebel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1262-6169","authenticated-orcid":false,"given":"P\u00e9ter","family":"K\u00f6rtv\u00e9lyessy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2258-1670","authenticated-orcid":false,"given":"Martin","family":"Holtkamp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6003-936X","authenticated-orcid":false,"given":"Verena","family":"Gaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"issue":"5","key":"13780_CR1","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1177\/1352458512443092","volume":"18","author":"CE Teunissen","year":"2012","unstructured":"Teunissen CE, Khalil M (2012) Neurofilaments as biomarkers in multiple sclerosis. 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Jakob D\u00f6rrfu\u00df reports personal fees from Eisai within the last 3\u00a0years, unrelated to the contents of the article. Martin Holtkamp received speaker\u2019s honoraria within the last 3\u00a0years from Angelini, Bial, Danone, Desitin, Eisai, Jazz Pharma, Neuraxpharm, and UCB, unrelated to the contents of the article. Verena Gaus received a speaker\u2019s honorarium (podcast recording) from Angelini Pharma within the last 3\u00a0years, unrelated to the contents of the article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the Ethics Committee of Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin (Application No. EA2\/263\/23) and conducted in accordance with the World Medical Association Declaration of Helsinki. Due to the retrospective study design and the use of pseudonymized clinical data, the requirement for written informed consent was waived by the Ethics Committee. Data protection regulations were strictly observed, and patient confidentiality was ensured.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}],"article-number":"246"}}