Association of Serum Homocysteine and hs-CRP with Idiopathic Generalised Epilepsy and Duration of Antiepileptic Drug Therapy BC01-BC05
Dr. DKV Prasad,
Assistant Professor, Department of Biochemistry, NRI Institute of Medical Sciences, Anil Neerukonda Hospital,
Bheemunipatnam (Mandal), Sangivalasa, Visakhapatnam-531162, Andhra Pradesh, India.
Introduction: Several human and experimental studies have revealed that chronic inflammation may play a vital role in neurodegenerative processes including epilepsy. There is accumulating evidence that inflammatory processes affect the pathophysiology of different epilepsy types.
Aim: To assess the concentrations of Homocysteine (Hcy) and High Sensitivity C-Reactive Protein (hs-CRP) in Idiopathic Generalised Epilepsy (IGE) patients and their association with IGE and duration of the Anti Epileptic Drugs (AEDs).
Materials and Methods: This case-control study consisted of 100 IGE patients (50 tonic–clonic, 15 absence and 35 myoclonic seizures) and equal number of healthy controls. Hcy levels were assayed by Centaur XP using ADVIA centaur Hcy; whereas hs-CRP levels by ELISA method using commercially available kits.
Results: The Hcy and hs-CRP levels were significantly increased in both the patient groups (<18 years and >18 years). Significant difference in the levels of Hcy was observed between different epilepsy types of <18 years patients (p=0.01), whereas hs-CRP in >18 years patients (<0.05). Significantly elevated levels of hs-CRP were noticed in non-responders group compared to responders (<0.05). There was a positive correlation between hs-CRP and Hcy (R2=0.44 and p<0.001) and significant difference in the levels of Hcy and hs-CRP was observed in the patient subgroups who were on AEDs for different time periods (=1 year, 1- =5 years and >5 years) (p=0.002 and p<0.05 respectively) since, AEDs can induce oxidative stress.
Conclusion: Hyperhomocysteinaemia (Hyper-Hcy) can induce as well as promote oxidative stress and hence, it can be implicated in neurodegeneration in epilepsy. Elevated levels of hs-CRP in non-responders may be resulted by the contribution of inflammatory pathways in ictogenesis in epileptic tissue, causing intractable epilepsy.