Systemic inflammatory indices are elevated in pediatric drug-resistant epilepsy versus self-limited epilepsy with centrotemporal spikes.

This real-world cohort study evaluated 140 pediatric patients to assess the clinical relevance of systemic inflammatory indices, specifically the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and C-reactive protein (CRP). The population included children diagnosed with drug-resistant epilepsy and those with self-limited epilepsy with centrotemporal spikes (SeLECTS). The primary objective was to determine if baseline inflammatory markers differed significantly between these two distinct epilepsy phenotypes.

The analysis revealed that baseline inflammatory indices (NLR, SII, and CRP) were significantly elevated in patients with drug-resistant epilepsy compared to those with SeLECTS. This difference was statistically significant with a p-value less than 0.05. The study also explored secondary outcomes related to neuroimmune dysregulation, JAK-STAT signaling, and Stat3 hub identification, though specific quantitative results for these secondary endpoints were not reported in the provided data.

Safety and tolerability data, including adverse events, discontinuations, or serious adverse events, were not reported in this observational study. A key limitation is that the specific molecular core connecting systemic inflammation and central nervous system signals, as well as the translational relevance to broader pediatric drug-resistant epilepsy, remains unclear. Consequently, while the association between elevated inflammatory markers and drug-resistant epilepsy is noted, causal relationships cannot be inferred from this cohort design.

The practice relevance of these findings is currently limited by the uncertainty regarding the underlying mechanisms. Clinicians should interpret these elevated indices as a potential biomarker of distinction rather than a definitive diagnostic tool or therapeutic target at this stage. Further research is needed to clarify the role of these systemic markers in pediatric epilepsy management.