Predictors of Seizure Severity using Neutrophil-to-Lymphocyte Ratio and C-Reactive Protein in Patients with Idiopathic Epilepsy

Elmotayam, Amal SE; Elmahdy Abdelfattah, Abdelrhman Mohamed; Mohamed Hasan, Wafaa Samir; Hafez, Hala Ahmad Fathy

doi:10.21608/zumj.2025.406380.4068

	Predictors of Seizure Severity using Neutrophil-to-Lymphocyte Ratio and C-Reactive Protein in Patients with Idiopathic Epilepsy
Zagazig University Medical Journal
Articles in Press, Accepted Manuscript, Available Online from 26 August 2025
Document Type: Original Article
DOI: 10.21608/zumj.2025.406380.4068
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Authors
Amal SE Elmotayam¹; Abdelrhman Mohamed Elmahdy Abdelfattah ²; Wafaa Samir Mohamed Hasan¹; Hala Ahmad Fathy Hafez ¹
¹Professor of Neurology Department, Faculty of Medicine- Zagazig University, Egypt
²Department of Neurology, Faculty of Medicine, Zagazig University, Egypt
Abstract
Background: Many researchers studying epilepsy have focused on the immune system in the past ten years. As a result, the body of knowledge regarding the role of several immunological variables in the incidence of seizures and epileptogenesis is expanding quickly. This study aimed at improving epilepsy prognosis via identification of inflammatory biomarkers as predictors of seizure severity in patients with idiopathic Epilepsy. Methods: This Case-control study was done in Intensive Care Unit and Epilepsy Outpaient Clinic at Neurology Department, Zagazig University Hospitals, during the period between February 2022 and March 2025. This study was conducted on 90 subjects; 45 patients )25 Females and 20 Males) with ages ranging from 19-75 years with mean age (39.27±13.07 years) and 45 age and sex matched controls (26 Females and 19 Males), with ages ranging from 19-74 years with mean age 40.67±16.33 years]. All patients were assessed within 72 hours of the seizure onset. Seizure severity was assessed by National Hospital Seizure Severity Scale, electroencephalogram, brain MRI and routine laboratory tests including CBC and CRP. Results: Neutrophil-to-Lymphocyte ratio (≥2.75) significantly independently increases the risk of severe epilepsy by 20.885 folds, while CRP (≥62.77) non-significantly independently increases the risk of severe epilepsy by 1.8 folds. Conclusion: Neutrophil-to-Lymphocyte ratio and C-Reactive Protein can be used as independent inflammatory predictors for seizure severity in patients with idiopathic epilepsy.
Keywords
Idiopathic epilepsy; seizure severity; neutrophil-tolymphocyte ratio; C-reactive protein


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