Open J Psychiatry Allied Sci. 2025 Dec 25. Epub ahead of print.

Evaluation of peripheral inflammatory markers in children and adolescents with epilepsy: a cross-sectional comparative study.

Choudhury HA, Purkayastha RN, Singha YSK.

Abstract

Background: Emerging evidence suggests that inflammation plays an important role in the pathophysiology of epilepsy. Haematological inflammatory markers such as neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) are simple and cost-effective indicators of systemic inflammation, though their clinical relevance in epilepsy remains uncertain. Aim: To evaluate the levels of NLR, MLR, and PLR in patients with epilepsy and assess their diagnostic significance. Methods: This hospital-based cross-sectional comparative study included 80 participants (40 epilepsy patients and 40 age- and gender-matched healthy controls) aged six to 18 years. Participants with recent infections, inflammatory disorders, or major systemic illnesses were excluded. Blood samples were analysed to calculate NLR, MLR, and PLR. Statistical analysis included Mann-Whitney U test, receiver operating characteristic (ROC) curve analysis, and binary logistic regression. Results: WBC count, NLR, MLR, and PLR were significantly higher in epilepsy patients compared to controls. MLR demonstrated the highest diagnostic accuracy [area under the curve (AUC)=0.799], followed by NLR (AUC=0.749) and PLR (AUC=0.642). Logistic regression showed significant associations of NLR, MLR, and PLR with epilepsy, with MLR emerging as the strongest predictor. Conclusion: Inflammatory markers, particularly MLR and NLR, are elevated in epilepsy and may serve as accessible biomarkers for diagnosis and risk assessment. Larger longitudinal studies are required for validation.

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