Investigation on Acute Phase Reactants and Oxidant - Antioxidant Parameters in Patients Diagnosed as Having Generalized Tonic Clonic Type Epilepsy on Antiepileptic Monotherapy and Polytherapy

Abstract

Objective: This study aimed to investigate the relationship between acute-phase reactants and oxidative stress and epilepsy. Methods: The patient group consisted of 67 patients who applied to the Pediatric Neurology outpatient clinic and were diagnosed with generalized type epilepsy according to ILAE classification, 33 were receiving monotherapy and 34 were receiving antiepileptic medication in the form of polytherapy. The control group included 30 healthy volunteer participants with similar sociodemographic characteristics in the same age range, without epilepsy or any known chronic disease. Total anti-Oxidant Status (TAS) and total Oxidant Status (TOS) were measured according to the method developed by Erel, and the oxidative stress index (OSI) was calculated. Sensitive C-reactive protein (Hs-CRP) levels were measured. Results: Both TOS and OSI levels of the patients who received antiepileptic monotherapy and polytherapy were statistically significantly higher than the control group (p = 0.004, the TOS levels of the patients who received antiepileptic monotherapy and polytherapy were 19.29 ± 1.27, 19.22 ± 1.26, respectively, control group 14.49 ± 1.75, OSI levels of patients receiving antiepileptic monotherapy and polytherapy 1.66 ± 0.12, 1.72 ± 0.11, control group 1.27 ± 0.11), respectively. The Hs-CRP level (0.59 ± 0.06 mg / L, 1.09 ± 0.06 mg / L, respectively) of the patients who received monotherapy and polytherapy was statistically significant compared to the control group (0.42 ± 0.02 mg / L) significantly higher. Conclusion: In this study, the findings suggest that epileptic seizures increase oxidative stress parameters and antioxidant mechanisms are insufficient to reduce oxidative damage. In addition, considering the high serum Hs-CRP levels, it is extremely important to develop treatment strategies that can control the inflammatory process in treating resistant epilepsy.

Keywords

• Epilepsy
• Oxidative Stress
• Sensitive C-Reactive Protein

Jeneralize Tonik Klonik Tip Epilepsi Tanısı Konulan, Monoterapi ve Politerapi Olarak Antiepileptik Tedavi Alan Hastalarda Akut Faz Reaktanları ve Oksidan-Antioksidan Parametrelerin Araştırılması

Abstract

Amaç: Bu çalışmada akut faz reaktanları ile oksidatif stres ve epilepsi arasındaki ilişkinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Hasta grubu, Çocuk Nörolojisi polikliniğine başvuran ve ILAE sınıflamasına göre jeneralize tip epilepsi tanısı alan, 33’ü monoterapi, 34’ü ise politerapi şeklinde antiepileptik ilaç tedavisi almakta olan 67 hastadan oluşmaktaydı. Kontrol grubu, epilepsi veya bilinen herhangi bir kronik hastalığı olmayan, aynı yaş aralığında benzer sosyodemografik özelliklere sahip özelliklere sahip 30 sağlıklı gönüllü katılımcıyı içeriyordu. Toplam anti-oksidan durumu (TAS) ve toplam oksidan durumu (TOS) Erel tarafından geliştirilen yönteme göre ölçülmüş ve oksidatif stres indeksi (OSI) hesaplanmıştır. Hassas C-reaktif protein (Hs-CRP) seviyeleri ölçüldü. Bulgular: Antiepileptik monoterapi ve politerapi alan hastaların hem TOS hem OSI düzeyleri kontrol grubuna göre istatistiksel olarak anlamlı derecede yüksek bulundu(p=0.004), antiepileptik monoterapi ve politerapi alan hastaların TOS düzeyleri sırasıyla 19.29±1.27, 19.22±1.26, kontrol grubu 14.49±1.75, antiepileptik monoterapi ve politerapi alan hastaların OSI düzeyleri sırasıyla 1.66±0.12, 1.72±0.11, kontrol grubu 1.27±0.11). Monoterapi ve politerapi alan hastaların Hs-CRP düzeyi (sırasıyla 0.59±0.06 mg/L, 1.09±0.06 mg/L), kontrol grubuna göre (0.42±0.02 mg/L) istatistiksel olarak anlamlı derecede yüksek bulundu. Sonuç: Bu çalışmada, epileptik nöbetin oksidatif stres parametrelerini arttırdığı ve antioksidan mekanizmaların oksidatif hasarı azaltmada yetersiz kaldığı sonucuna varılmıştır. Ayrıca yüksek serum Hs-CRP seviyeleri göz önüne alındığında, dirençli epilepsinin tedavisinde inflamatuar süreci kontrol edebilen tedavi stratejilerinin geliştirilmesi son derece önemlidir.

Keywords

• Epilepsi
• Oksidatif Stres
• Sensitive C-Reactive Protein

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