Bcl-2 and FAS as Apoptosis-Related Markers in Patients with Convulsive Status Epilepticus

<b>Background</b>: Status epilepticus (SE) is a neurological emergency associated with neuronal injury and activation of apoptotic pathways. While these mechanisms are well described in experimental models, evidence in humans is limited. This study evaluated Bcl-2 and FAS-key apoptosis-related proteins-in the serum and cerebrospinal fluid (CSF) of patients with convulsive SE. <b>Methods</b>: Between February 2024 and January 2025, CSF and serum samples were collected from 18 adults with convulsive SE within 48 h of onset, and from 15 control subjects. Patients with acute brain injury, stroke, tumors, or central nervous system infections were excluded. Bcl-2 and FAS concentrations were quantified using ELISA. Serum samples were obtained at diagnosis (S1), 24 h (S2), and 7 days (S3). <b>Results</b>: CSF Bcl-2 levels were significantly higher in SE patients compared with controls (z = 4.1, <i>p</i> < 0.001). CSF FAS levels did not differ significantly (z = 0.07, <i>p</i> = 0.94). No differences in serum Bcl-2 were observed. In contrast, serum FAS concentrations were significantly elevated at all three time points in SE patients compared with controls (S1-S3; all <i>p</i> < 0.001). <b>Conclusions</b>: Convulsive SE is associated with distinct apoptotic responses in the central nervous system and periphery. Elevated CSF Bcl-2 may reflect acute neuroprotective or stress-related responses, whereas persistently increased serum FAS suggests systemic apoptotic activation. These findings highlight the potential prognostic and therapeutic relevance of apoptosis-related biomarkers in SE.