Study of inflammatory markers in seizure disorder

Abstract

Background: Over the past 10 years an increasing body of clinical and experimental evidence has provided strong support to the hypothesis that inflammatory processes within the brain might constitute a common and crucial mechanism in the pathophysiology of seizures and epilepsy. Objective: The study aimed to focus on various markers for inflammation in seizure like WBC, elevated BT, HSCRP along with serum ferritin and ESR.   Methodology: A tertiary care hospital based prospective, observational and comparative study was conducted to study the inflammatory markers in seizures on 100 patients – 50 patients each of first episode of seizure and known case of seizure, who reported to the Department of General medicine (OPD, MMW and FMW), Geriatric medicine (MMW and FMW), Neurology (OPD) and Emergency medicine (ER) at Mahatma Gandhi Mission Medical college, Navi Mumbai.Result: Most of the study population who presented with 1st episode of seizure belonged to the age up to 25 years (26%) and 26 to 35 years (22%) while most of the study population who were known case of seizure disorder belonged to the younger age group of less than and equal to 25 years (36%). ESR was increased in 18% of cases with 1^st episode of seizure and 16% of known case of seizure. It was most commonly increased in Drug Default Seizure (19.4%) followed by CNS Infections (16.1 %). Raised ESR levels were most commonly associated with generalized tonic clonic seizures. Serum Ferritin was equally increased in both cases with 1st episode of seizure (4%) and known case of seizure (4%). It was increased most commonly in CNS Infections (17.2 %) followed by Drug Default Seizure (16.1%), Post stroke seizure (15.1%),  Alcohol withdrawal seizure  (15.1%) and Scar Epilepsy (7.52%). Increased levels of ferritin was most commonly observed in Generalized tonic clonic seizure (76.3%) followed by complex partial seizure (10.8%).Conclusion: Inflammatory markers except ESR and FERRITIN, WBC and HSCRP were increased most commonly in GTCS. Markers of inflammation evaluated in the present study cannot not be used as diagnostic markers for different type of seizures since their correlation did not reach the statistically significant value. Study reported significant increase in HSCRP levels in GTCS (64%). It is observed that WBC levels were increased in 34% of cases with 1^st episode of seizure and 50% of known case of seizure