Inflammatory markers associated with seizures

Area of Science:

• Neurology
• Emergency Medicine
• Clinical Pathology

Background:

• Seizures can mimic infection by causing systemic changes like fever and elevated inflammatory markers.
• Distinguishing seizure-induced responses from true infection is crucial for appropriate patient management.

Purpose of the Study:

• To investigate seizure-induced inflammation-like responses.
• To identify clinical features that differentiate these responses from concurrent infections.

Main Methods:

• Prospective study of 140 emergency room visits for seizures.
• Defined inflammation-like responses as elevated body temperature, white blood cell count, or C-reactive protein.
• Assessed seizure characteristics, neurological status, and infection presence post-discharge.

Main Results:

• Inflammation-like responses occurred in 56.3% of visits; 19.3% had concurrent infection.
• Among those with inflammation-like responses, 34.7% had infection.
• Milder fever (<39°C) and lower C-reactive protein (<6 mg/dl) were associated with non-infectious causes, while leukocytosis showed no difference.
• Fever occurred only with generalized tonic-clonic seizures; leukocytosis and elevated C-reactive protein occurred with all seizure types.
• Body temperature normalized within 8 hours in uncomplicated cases.

Conclusions:

• Seizures frequently induce inflammation-like responses, complicating infection diagnosis.
• Elevated temperature (>39°C) without generalized tonic-clonic seizures, persisting >8 hours, or C-reactive protein levels >6 mg/dl warrant investigation for infection.