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Subject Area

Pediatrics

Article Type

Original Study

Abstract

Background Epileptic seizures are due to excessive, abnormal, or synchronous signaling, or depolarization, in the brain cells. Homocysteine (Hcy) and interleukin-6 (IL-6) are a thiol metabolite derived from the demethylation of methionine. It is widely known that folate deficiency takes place in a few epileptic patients taking antiepileptic drugs (AEDs), causing decreased remethylating or transculturation of Hcy. The effect of systemic inflammatory responses on generalized motor seizures in pediatric patients with epilepsy needs to be evaluated. Objectives To measure serum levels of Hcy and IL-6 in children with idiopathic epilepsy in relation to their clinical findings. Patients and methods A case–control study was conducted on 80 children recruited from outpatient Pediatric Neurology Clinics and inpatients admitted to Pediatric Department, Menoufia University Hospitals, during January 2020–March 2021. The participants include 40 epileptic children with idiopathic epilepsy, in which 15 children were recently diagnosed (≤ 1 month of presentation) before the start of AED and 25 children with idiopathic epilepsy on anti-epibiotic drugs for more than or equal to 1 year. In total, 40 children matched for age and sex serving as controls. Full history taking, through clinical examination, and laboratory investigation emphasized that serum Hcy and IL-6 levels were investigated. Results Serum Hcy and IL-6 were significantly higher among those with idiopathic epilepsy controls (P = 0.004, 0.001, respectively). There was a significant positive correlation between serum Hcy level and alanine transaminases, aspartate transaminase, urea, mean platelet volume, and platelet-count test. The best cutoff point of interleukin-6 for prediction of epilepsy was more than 50 ng/ml, with sensitivity 87.5%, specificity 87.5%, and accuracy 85.21%, while the best cutoff point of serum Hcy was more than 12 ng/ml, with sensitivity 86%, specificity 91.9%, and accuracy 90.35% for diagnosis of epilepsy. Conclusion Hcy and interleukin-6 are significantly increased in patients with idiopathic epilepsy on AEDs weather monotherapy or polytherapy. It is suggested that all the patients who are on AEDs, whether monotherapy or polytherapy, should be screened for Hcy levels to avoid the adverse effects of hyper-Hcy and be treated accordingly if the levels are found to be high.

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