CSF Glucose
CSF glucose, also known as cerebrospinal fluid glucose or glycorrhachia, is a measurement used to determine the concentration of glucose in cerebrospinal fluid. The normal reference range for CSF glucose is typically between 50-80 mg/dL.
If the levels are lower than this range, it may indicate an infection or other medical conditions.
The CSF glucose test is an important diagnostic tool used to assess various neurological and infectious diseases. It helps doctors evaluate conditions like meningitis, encephalitis, and other central nervous system disorders.
Abnormal results, such as high CSF glucose levels, can be indicative of conditions like hyperglycemia, infection (bacterial or fungal), or inflammation of the central nervous system.
- Glucose levels in CSF normally reflect the levels seen in the blood. There may be a 2–4 hour lag in the CSF level when compared to the blood level.
- Whilst not diagnostic, low glucose levels, as compared to plasma levels, are seen in bacterial meningitis, cryptococcal meningitis, malignant involvement of the meninges and sarcoidosis.
- Glucose levels are usually normal in viral infections of the CNS.
References:
Leen WG, Willemsen MA, Wevers RA, Verbeek MM. Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice. PLoS One. 2012;7(8):e42745. doi: 10.1371/journal.pone.0042745. Epub 2012 Aug 6. PMID: 22880096; PMCID: PMC3412827.
Tigchelaar C, van Zuylen ML, Hulst AH, Preckel B, van Beek AP, Kema IP, Hermanides J, Absalom AR. Elevated cerebrospinal fluid glucose levels and diabetes mellitus are associated with activation of the neurotoxic polyol pathway. Diabetologia. 2022 Jul;65(7):1098-1107. doi: 10.1007/s00125-022-05693-7. Epub 2022 Apr 5. PMID: 35380232; PMCID: PMC9174140.
Powers WJ. Cerebrospinal fluid to serum glucose ratios in diabetes mellitus and bacterial meningitis. Am J Med. 1981 Aug;71(2):217-20. doi: 10.1016/0002-9343(81)90108-x. PMID: 7258216.
Tan QC, Xing XW, Zhang JT, He MW, Ma YB, Wu L, Wang X, Wang HF, Yu SY. Correlation between blood glucose and cerebrospinal fluid glucose levels in patients with differences in glucose metabolism. Front Neurol. 2023 Apr 27;14:1103026. doi: 10.3389/fneur.2023.1103026. Erratum in: Front Neurol. 2023 Jul 03;14:1239968. PMID: 37181574; PMCID: PMC10174426.
What does it mean if your CSF Glucose result is too high?
Spinal fluid glucose may be elevated 2–4 hours after hyperglycemia.
CSF (Cerebrospinal Fluid) glucose levels can be elevated in certain medical conditions. Here are some key situations in which CSF glucose may be elevated:
Diabetes: Some cases of diabetes can result in elevated cerebrospinal fluid glucose levels. This may be due to alterations in glucose metabolism.
It's essential to note that CSF glucose levels are typically lower than blood glucose levels and serve as a diagnostic marker for specific neurological and infectious conditions. Elevated CSF glucose is not a common finding and is usually indicative of an underlying medical issue.
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What does it mean if your CSF Glucose result is too low?
Spinal fluid glucose is decreased in many cases of:
→ Bacterial meningitis (CSF glucose levels ≤20 mg/dL are highly correlated with bacterial meningitis.)
→ Mumps meningitis
→ Meningococcal meningitis
→ Tuberculosis meningitis
→ Herpes meningitis
→ Neurosyphilis
→ Sarcoidosis
→ Cancer
→ Subarachnoid hemorrhage
Glucose is usually normal in viral meningitis, but in herpes or mumps meningoencephalitis, lymphocytic choriomeningitis, and enteroviruses, glucose may be low.
Other very uncommon causes of low CSF glucose include meningeal cysticercosis, trichinosis, and with the chemical meningitis which accompanies intrathecal therapy.
Low CSF glucose may also occur in subarachnoid hemorrhage and neoplasia (eg, medulloblastoma).
Low CSF glucose may be found in CNS leukemia.
Decrease has led to the diagnosis of insulinoma presenting with CNS symptoms.
Rheumatoid meningitis and lupus myelopathy may cause low CSF glucose.
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