Abstract
BACKGROUND: Pediatric epilepsy presents challenges in treatment optimization, with a significant proportion of patients experiencing inadequate seizure control despite anti-seizure medications (ASMs) therapy. Recent research has indicated the involvement of neuroinflammation and immune-mediated mechanisms in epilepsy pathogenesis, suggesting a potential interplay between immunological factors and ASMs responsiveness. This study aimed to investigate the role of immunological factors in pediatric generalized, focal epilepsy and their interaction with ASMs mechanisms to understand their potential influence on treatment outcomes. METHODS: A retrospective cohort study was conducted involving 136 pediatric epilepsy patients, categorized into Anti-seizure medications Insensitive Group (n = 67) and Anti-seizure medications Sensitive Group (n = 69). Immunoglobulin levels and immunological factors, including cytokines, were assessed before treatment. Seizure characteristics and ASMs levels were also analyzed. Associations between immunological factors, seizure characteristics, and ASMs sensitivity was evaluated. RESULTS: The study revealed significant differences in immunological factors, including interleukin-6 (IL-6), IL-1β and IL-10 levels, between the insensitive and sensitive groups. Furthermore, seizure frequency, drug-resistant seizures, seizure severity, seizure-free period, and status epilepticus all demonstrated significant correlations with the sensitivity to ASMs, with negative correlations for seizure frequency, drug-resistant seizures, seizure severity, and positive correlations for seizure-free period and status epilepticus. CONCLUSION: The study highlights the complex interplay between immune function, seizure characteristics, and ASMs mechanisms, underscoring the need for a comprehensive understanding of the immunological modulation of drug response in pediatric epilepsy. CLINICAL TRIAL NUMBER: Not applicable.