Study the Role of Pro-Inflammatory Cytokines (Interleukin 1-Beta, Interleukin 6) and High Sensitivity C-reactive protein in Children with Refractory Epilepsy

Background: The International League Against Epilepsy (ILAE) has defined epilepsy as a condition in which at least two unprovoked (or reflex) seizures happening for more than 24 hours part, or it can involve one unprovoked seizure if there is a recurrence possibility over the subsequent 10 years, or if the patient has been diagnosed with epilepsy syndrome. A failure of seizures controlling with at least 2 or more antiepileptic drugs for at least 2 years with good compliance and adequate serum therapeutic drug levels with a minimum frequency of seizures with no more than 3 months of free seizures is the definition of refractory epilepsy.

Methods: This case control research was conducted on 130 children selected from the outpatient clinic of pediatric neurology. They were divided into three groups: group I with refractory epilepsy, group II with controlled idiopathic epilepsy and group III were healthy children. All children enrolled in the study were subjected to the following: routine laboratory investigations (serum antiepileptic drugs, complete blood count and liver and renal function tests) and specific laboratory investigations (estimation of serum interleukin-6, IL-1β and hs-CRP) electroencephalography (EEG), brain magnetic resonance imaging (MRI).

Results: Interleukin -6, interleukin -1 beta and high sensitivity C-reactive protein serum levels were significantly higher in refractory epilepsy children, than in those with controlled epilepsy and the control children (P<0.001). IL-6, IL-1β and hs-CRP serum levels showed no significant difference in children with controlled epilepsy in comparison to healthy control children (P>0.05).

Conclusions: The production of IL-1β, IL-6 and hs-CRP has been increased in the serum of refractory epilepsy children. Our findings suggest that this systemic inflammatory reaction with increasing IL-6, IL-1β and hs-CRP mean serum levels are effective biomarkers for epileptogenesis in the children and may contribute to refractory epilepsy and potentially can be correlated with the severity and prognosis of the disease.