SYMPTOMS of central nervous system (CNS) dysfunction are known to ensue when the pH of cerebrospinal fluid (CSF) is lowered. The normal spinal fluid pH in humans is 7.31.1 Coma occurs in patients with CSF pH values below 7.15,2 and significant abnormalities of mentation are found with values less than 7.25.1,3 These neurological changes are reversible.
The biochemical reasons for the functional derangement associated with CSF acidosis are not clear. Activities of almost all enzyme systems are sensitive to pH change,4 and a number of physiologically important enzymes are most active at pH 7.5. The property of excitability very likely is not an enzymatic process in neural tissue, but it is undoubtedly dependent upon chemical properties of the membrane and to some extent can be altered by changing pH.
There are several ways by which acidosis might affect neuronal function. These include (1) damage to
Swanson PD. Acidosis and Some Metabolic Properties of Isolated Cerebral Tissues. Arch Neurol. 1969;20(6):653–663. doi:10.1001/archneur.1969.00480120099010
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