Zmiany biomarkerów we krwi po napadzie epilepsji u pacjentów z lekooporną epilepsją ogniskową

Abstract Approximately one-third of patients with epilepsy are resistant to antiseizure medications. Identifying biomarkers associated with seizures may improve clinical monitoring. We enrolled 39 adult patients admitted for presurgical evaluation who underwent continuous video EEG monitoring. Blood samples were collected during an interictal period (no seizures for at least 24 hours), and a post-seizure period (EEG-captured seizure within 24 hours before sampling). Biochemical and hematological parameters were retrieved from records, and a 12-cytokine panel was measured using flow-cytometry. Paired comparisons revealed significant post-ictal increases in neutrophil proportion, neutrophil-to-lymphocyte ratio (NLR), and monocyte-to-lymphocyte ratio (MLR), alongside decreases in lymphocyte and eosinophil proportions. IL-6, white blood cell, and platelet counts showed trends towards post-ictal increases. Neutrophil proportion, NLR, and MLR were negatively correlated with time since the last seizure, while lymphocyte and eosinophil proportions showed positive correlations. Platelet count was negatively correlated with time to the next seizure. Nominal trends of greater immune dysregulation were observed in patients with multiple seizures or generalized seizures. No changes were observed in 15 controls without epileptic seizures. These results reveal peri-ictal blood biomarker changes in refractory focal epilepsy, potentially reflecting post-ictal immune alterations, and thus may help characterize seizure-related biological changes and support future clinical applications.