Postiktale Veränderungen der Serumkonzentration proinflammatorischer Zytokine bei Patienten mit Temporallappenepilepsie

Inflammatory mechanisms are involved in the pathogenesis of epilepsy. Vice versa, immune functions are regulated by the brain. To further characterize the relationship between temporal lobe epilepsy (TLE) and the immune system, we measured postictal changes in serum levels of the immunomodulatory cytokines IL-1β, IL-6 and TNFα in patients with well-defined TLE and determined modifying factors. Serum levels of IL-1β, IL-6 and TNFα were quantified at baseline as well as immediately, 1 h and 24 h after a complex partial (CPS) or secondary generalized tonic-clonic seizure (GTCS) during video-EEG monitoring in 25 patients suffering from temporal lobe epilepsy. IL-6 increased by 51 % immediately after the seizure (p<0.01) and remained elevated for 24 hours. This increase lacked in patients with hippocampal sclerosis (HS; n=16, mean increase 28 %, p>0.5, vs. 112 %, p<0.01 in patients without HS). IL-6 levels were higher after right-sided seizures as compared to leftsided seizures 24 h after the seizure (8.7 pg/mL vs. 3.4 pg/mL, p<0.05). In patients taking valproate (VPA), the levels of IL-1β were higher as compared to patients not treated with VPA. The results suggest 1) a relationship between the cytokine system and characteristics of TLE such as side and etiology and 2) an influence of VPA on the cytokine metabolism. Further studies are warranted to determine the pathophysiological role of these alterations.