Interleukin-4 and tumor necrosis factor-alpha levels in children with febrile seizures

The pathophysiology of febrile seizures remains unclear. Cytokines have been suggested to play a role in the pathogenesis of febrile seizures. We compared TNF-α and IL-4 levels in patients with febrile seizure (FS) with those in controls and identified the relationship between cytokines and various other factors.

Fifty FS patients who visited Konkuk University Hospital from December 2015 to December 2016 were included. Thirty-nine patients who had fever without seizures were enrolled as the control group. Serum samples from febrile patients with a history of febrile seizures without present seizures (FPH) (N = 12) and from the afebrile seizure (AF) group (N = 13) were also analyzed. In the FS group, we compared cytokine levels among patients stratified by sex, family history, seizure recurrence, duration of seizure and serum lactate levels.

The median serum TNF-α level in the FS group (19.54 pg/mL) was significantly higher than that in the control group (15.86 pg/mL). Higher median serum IL-4 levels were detected in the FS group (3.38 pg/mL) than in the control group (3.30 pg/mL). In the FS group, the serum IL-4 and TNF-α levels correlated with seizure recurrence and serum lactate levels, but they did not correlate with family history, duration of seizures or sex.

Our study supports the hypothesis that TNF-α production is involved in the pathogenesis of febrile seizures. IL-4 is believed to be involved in the pathogenesis of febrile seizures. The number of seizures and lactate levels were correlated with IL-4 and TNF-α levels.