The role of plasma cytokine levels in the differential diagnosis of epileptic and psychogenic non-epileptic seizures

Aim: In this study, we aimed to evaluate the use of plasma cytokine levels in the differential diagnosis of epileptic and psychogenic nonepileptic seizures. Material and Methods: Thirty-three epilepsy patients with generalized seizures, 23 patients with psychogenic nonepileptic seizures and 31 control patients were included in the study. Blood was drawn from all patients at 1 and 24 hours after seizures, and IL-1 beta, IL-1Ra, IL-6 and TNF-alpha levels were measured. The results were evaluated in terms of differences by groups and hours. Results: A significant increase was observed in IL-1 beta, IL-6 and IL-1Ra levels in the epileptic seizure group compared to controls in the first hour. This increase is significantly different only for IL-1 beta with the psychogenic non-epileptic seizure group. IL-1 beta appears to be the marker that best distinguishes the epileptic seizure group from both control and psychogenic non-epileptic seizure groups. IL-1 beta values were not significantly different between the 1st and 24th- hour measurements in the epileptic seizure group. TNF-alpha levels decrease significantly in psychogenic non-epileptic seizure patients compared to both epileptic seizure and control groups, but show significant increase over time between 1 and 24 hours. Discussion: Checking blood cytokine levels can be used as an adjunct method in the differential diagnosis when distinguishing between epileptic and psychogenic non-epileptic seizures. In our study, the importance of blood cytokine levels in the differential diagnosis and the time at which they are checked were shown.