The role of lipid profile and inflammotry markers in diffrentiating between focal and generalized types of seizures in pediatric epilepsy patients

Serap Bilge; Hüseyin Bilgin

doi:10.18621/eurj.1745159

The role of lipid profile and inflammotry markers in diffrentiating between focal and generalized types of seizures in pediatric epilepsy patients

Abstract

Objectives: Seizures result from excessive and abnormal neuronal excitation, accompanied by pathophysiological processes such as inflammation, oxidative stress, and apoptotic cell death. Previous studies have demonstrated that patients with epilepsy often exhibit dysregulated inflammatory, vascular, and metabolic pathways, with certain seizure types associated with high pro-inflammatory cytokines. We aimed to investigate whether lipid profile parameters and inflammatory markers can be used to differentiate between focal and generalized seizures in pediatric epilepsy patients.

Methods: A total of 100 pediatric epilepsy patients and 100 age- and sex-matched healthy controls were recruited at Diyarbakır Children's Hospital between December 2021 and March 2023. Ethical approval was obtained from the institutional review board, and informed consent was secured from parents/guardians. Lipid levels (triglycerides, total cholesterol, low-density lipoprotein [LDL] cholesterol, high-density lipoprotein [HDL]) cholesterol) and inflammatory markers (ferritin, glucose, white blood cell count [WBC], C-reactive protein [CRP]) were analyzed using standard laboratory methods.

Results: The mean age was 9.2±4.4 years in the epilepsy group and 8.9±4.9 years in controls. Triglycerides, LDL, and total cholesterol levels were significantly higher in epilepsy patients compared to controls (P<0.05). Similarly, ferritin, glucose, WBC count, and CRP were elevated in the epilepsy group. Among seizure subtypes, patients with generalized seizures demonstrated significantly higher triglyceride, LDL, and total cholesterol levels compared with those with focal seizures (P<0.05). The WBC count was the only inflammatory marker that was elevated considerably in the generalized seizure group.

Conclusions: Pediatric patients with epilepsy, particularly those with generalized seizures, exhibit higher lipid and inflammatory marker levels compared to controls and patients with focal seizures. These findings suggest potential diagnostic and prognostic roles for metabolic and inflammatory markers in seizure classification.

Keywords

Ethical Statement

This study was approved by the University of Health Sciences Gazi Yaşargil Training and Research Hospital Clinical Research Ethics Committee (Decision No: 2023/492; date: 04.08.2023). All procedures were conducted in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments. Written informed consent was obtained from all participants and their legal guardians.

Thanks

Thanks to all health professionals of Diyarbakır Children's Hospital

References

1. Vezzani A, French J, Bartfai T, Baram TZ. The role of inflammation in epilepsy. Nat Rev Neurol. 2011;7(1):31-40. doi:10.1038/nrneurol 2010.178.
2. Lehtimaki KA, Keranen T, Palmio J, et al. Increased plasma levels of cytokines after seizures in localization-related epilepsy. Acta Neurol Scand. 2007;116(4):226-230. doi:10.1111/j.1600-0404.2007.00882.x.
3. Pascotini ET, Flores AE, Kegler A, et al. Apoptotic markers and DNA damage are related to the late phase of stroke: Involvement of dyslipidemia and inflammation. Physiol Behav. 2015;151:369-378. doi:10.1016/j.physbeh.2015.08.005.
4. Specchio N, Wirrell EC, Scheffer IE, et al. International League Against Epilepsy classification and definition of epilepsy syndromes with onset in childhood: Position paper by the ILAE Task Force on Nosology and Definitions. Epilepsia. 2022;63(6):1398-1442. doi: 10.1111/epi.17241.
5. Kegler A, Pascotini ET, Caprara ALF, et al. Relationship between seizure type, metabolic profile, and inflammatory markers in blood samples of patients with epilepsy. Epileptic Disord. 2021 Feb 1;23(1):74-84. doi: 10.1684/epd.2021.1236.
6. Mao LY, Ding J, Peng WF, et al. Interictal interleukin-17A levels are elevated and correlate with seizure severity of epilepsy patients. Epilepsia. 2013;54(9):e142-145. doi:10.1111/epi.12337.
7. Choi J, Koh S. Role of brain inflammation in epileptogenesis. Yonsei Med J. 2008;49(1):1-18. doi:10.3349/ymj.2008.49.1.1.
8. Fabene PF, Bramanti P, Constantin G. The emerging role for chemokines in epilepsy. J Neuroimmunol. 2010;224(1-2):22-7. doi:10.1016/j.jneuroim.2010.05.016.

9. Wang C, Zhai J, Zhou X, Chen Y. Lipid metabolism: Novel approaches for managing idiopathic epilepsy. Neuropeptides. 2024;108:102475. doi: 10.1016/j.npep.2024.102475.
10. Soltani Khaboushan A, Yazdanpanah N, Rezaei N. Neuroinflammation and Proinflammatory Cytokines in Epileptogenesis. Mol Neurobiol. 2022;59(3):1724-1743. doi: 10.1007/s12035-022-02725-6.
11. Rowley S, Patel M. Mitochondrial involvement and oxidative stress in temporal lobe epilepsy. Free Radic Biol Med. 2013;62:121-131. doi:10.1016/j.freeradbiomed.2013.02.002.
12. Frantseva MV, Velazquez JL, Hwang PA, Carlen PL. Free radical production correlates with cell death in an in vitro model of epilepsy. Eur J Neurosci. 2000;12(4):1431-1439. doi:10.1046/j.1460-9568.2000.00016.x.
13. Leszek J, Barreto GE, Gąsiorowski K, Koutsouraki E, Ávila-Rodrigues M, Aliev G. Inflammatory Mechanisms and Oxidative Stress as Key Factors Responsible for Progression of Neurodegeneration. CNS Neurol Disord Drug Targets. 2016;15(3):329-336. doi:10.2174/1871527315666160202125914.
14. Skeldon AM, Faraj M, Saleh M. Caspases and inflammasomes in metabolic inflammation. Immunol Cell Biol. 2014;92(4):304-313. doi:10.1038/icb.2014.5.
15. Budihardjo I, Oliver H, Lutter M, Luo X, Wang X. Biochemical pathways of caspase activation during apoptosis. Annu Rev Cell Dev Biol. 1999;15:269-290. doi:10.1146/annurev.cellbio.15.1.269.
16. Gaitatzis A, Carroll K, Majeed A, W Sander J. The epidemiology of the comorbidity of epilepsy in the general population. Epilepsia. 2004;45(12):1613-1622. doi:10.1111/j.0013-9580.2004.17504.x.
17. Elliott JO, Lu B, Shneker B, Charyton C, Layne Moore J. Comorbidity, health screening, and quality of life among persons with a history of epilepsy. Epilepsy Behav. 2009;14(1):125-129. doi:10.1016/j.yebeh.2008.10.013.
18. Janszky I, Hallqvist J, Tomson T, Ahlbom A, Mukamal KJ, Ahnve S. Increased risk and worse prognosis of myocardial infarction in patients with prior hospitalization for epilepsy. Brain. 2009;132(Pt 10):27982-804. doi:10.1093/brain/awp216.
19. Ding D, Wang W, Wu J, et al. Premature mortality in people with epilepsy in rural China: a prospective study. Lancet Neurol. 2006;5(10):823-827. doi: 10.1016/S1474-4422(06)70528-2.
20. Neligan A, Bell GS, Johnson AL, Goodridge DM, Shorvon SD, Sander JW. The long-term risk of premature mortality in people with epilepsy. Brain. 2011;134(Pt 2):388-395. doi:10.1093/brain/awq378.
21. Adibhatla RM, Hatcher JF. Altered lipid metabolism in brain injury and disorders. Subcell Biochem. 2008;49:241-268. doi:10.1007/978-1-4020-8831-5_9.
22. Park YM. CD36, a scavenger receptor implicated in atherosclerosis. Exp Mol Med. 2014;46(6):e99. doi:10.1038/emm.2014.38.
23. Hermann BP, Sager MA, Koscik RL, Young K, Nakamura K. Vascular, inflammatory, and metabolic factors associated with cognition in aging persons with chronic epilepsy. Epilepsia. 2017;58(11):e152-e156. doi:10.1111/epi.13891.
24. Norata GD, Catapano AL. Molecular mechanisms responsible for the anti-inflammatory and protective effect of HDL on the endothelium. Vasc Health Risk Manag. 2005;1(2):119-129. doi:10.2147/vhrm.1.2.119.64083.
25. Stredny C, Rotenberg A, Leviton A, Loddenkemper T. Systemic inflammation as a biomarker of seizure propensity and a target for treatment to reduce seizure propensity. Epilepsia Open. 2023;8(1):221-234. doi: 10.1002/epi4.12684.
26. Kobylarek D, Iwanowski P, Lewandowska Z, et al. Advances in the Potential Biomarkers of Epilepsy. Front Neurol. 2019;10:685. doi: 10.3389/fneur.2019.00685.
27. Guo HL, Dong N, Hu YH, et al. Serum HDL-C levels in children with epilepsy: a single-center retrospective study. Front Nutr. 2025;12:1523426. doi: 10.3389/fnut.2025.1523426.
28. Aygun D, Uzun H. Association of Comorbidity and Inflammatory and Nutritional Markers with Epilepsy and Seizure Frequency. Nutrients. 2025;17(11):1847. doi: 10.3390/nu17111847.
29. Guo HL, Wang WJ, Dong N, et al. Integrating metabolomics and lipidomics revealed a decrease in plasma fatty acids but an increase in triglycerides in children with drug-refractory epilepsy. Epilepsia Open. 2023;8(2):466-478. doi: 10.1002/epi4.12712.
30. Chen J, Yu H, Liu H, et al. Causal relationship between immune cells and epilepsy mediated by metabolites analyzed through Mendelian randomization. Sci Rep. 2024;14(1):19644. doi: 10.1038/s41598-024-70370-1.

Details

Primary Language

English

Subjects

Pediatric Neurology

Journal Section

Research Article

Authors

Serap Bilge ^*
0000-0002-4265-3363
Türkiye

Hüseyin Bilgin
0000-0002-5946-7356
Türkiye

Early Pub Date

August 26, 2025

Publication Date

September 4, 2025

Submission Date

July 17, 2025

Acceptance Date

August 24, 2025

Published in Issue

Year 2025 Volume: 11 Number: 5

DOI

https://doi.org/10.18621/eurj.1745159

IZ

https://izlik.org/JA55KA86XD

Cite

RIS / Bibtex

APA

Bilge, S., & Bilgin, H. (2025). The role of lipid profile and inflammotry markers in diffrentiating between focal and generalized types of seizures in pediatric epilepsy patients. The European Research Journal, 11(5), 934-943. https://doi.org/10.18621/eurj.1745159

AMA

1.Bilge S, Bilgin H. The role of lipid profile and inflammotry markers in diffrentiating between focal and generalized types of seizures in pediatric epilepsy patients. Eur Res J. 2025;11(5):934-943. doi:10.18621/eurj.1745159

Chicago

Bilge, Serap, and Hüseyin Bilgin. 2025. “The Role of Lipid Profile and Inflammotry Markers in Diffrentiating Between Focal and Generalized Types of Seizures in Pediatric Epilepsy Patients”. The European Research Journal 11 (5): 934-43. https://doi.org/10.18621/eurj.1745159.

EndNote

Bilge S, Bilgin H (September 1, 2025) The role of lipid profile and inflammotry markers in diffrentiating between focal and generalized types of seizures in pediatric epilepsy patients. The European Research Journal 11 5 934–943.

IEEE

[1]S. Bilge and H. Bilgin, “The role of lipid profile and inflammotry markers in diffrentiating between focal and generalized types of seizures in pediatric epilepsy patients”, Eur Res J, vol. 11, no. 5, pp. 934–943, Sept. 2025, doi: 10.18621/eurj.1745159.

ISNAD

Bilge, Serap - Bilgin, Hüseyin. “The Role of Lipid Profile and Inflammotry Markers in Diffrentiating Between Focal and Generalized Types of Seizures in Pediatric Epilepsy Patients”. The European Research Journal 11/5 (September 1, 2025): 934-943. https://doi.org/10.18621/eurj.1745159.

JAMA

1.Bilge S, Bilgin H. The role of lipid profile and inflammotry markers in diffrentiating between focal and generalized types of seizures in pediatric epilepsy patients. Eur Res J. 2025;11:934–943.

MLA

Bilge, Serap, and Hüseyin Bilgin. “The Role of Lipid Profile and Inflammotry Markers in Diffrentiating Between Focal and Generalized Types of Seizures in Pediatric Epilepsy Patients”. The European Research Journal, vol. 11, no. 5, Sept. 2025, pp. 934-43, doi:10.18621/eurj.1745159.

Vancouver

1.Serap Bilge, Hüseyin Bilgin. The role of lipid profile and inflammotry markers in diffrentiating between focal and generalized types of seizures in pediatric epilepsy patients. Eur Res J. 2025 Sep. 1;11(5):934-43. doi:10.18621/eurj.1745159