Clinical trial NCT05571371: Inflammatory Biomarkers in Psychogenic Non-epileptic Seizure
Official title: Possible Role of Inflammatory Serum Biomarkers in Differentiation Between Epileptic Seizure and Psychogenic Non-epileptic Seizure
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Localization-Related (Focal) (Partial) Idiopathic Epilepsy and Epileptic Syndromes With Seizures of Localized Onset
TRAIL: Tumor Necrosis Factor Related Apoptosis Inducing Ligand MCP-2
MCP-2: Monocyte Chemo-attractant Protein-2
Lead sponsor: Assiut University
Sponsor class: OTHER
First posted: 2022-10-07
Enrollment: 90
Sex: ALL
Minimum age (years): 12
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_CONTROL
Time perspective: RETROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: patients diagnosed as epileptic seizure are aged \>12 years patients diagnosed as psychogenic non-epileptic seizure are aged \>12 years Normal healthy control for comparison. Heathy control are aged \>12 years with no history of lifetime seizures or suspected seizures or febrile seizure

Brief summary: 1. Evaluation of the role of TRAIL and MCP-2 in differentiation between epileptic seizure and psychogenic non-epileptic seizure.
2. Possible role to predict the prognosis of patients with epileptic seizure.

Detailed description: Epilepsy is one of the most prevalent neurological disorders characterized by frequent somatic and psychiatric co-morbidities(1). Accurate diagnosis of epilepsy is challenging because clinicians rarely observe the actual clinical seizure outside of the hospital. Furthermore, psychogenic nonepileptic seizures (PNES) can mimic epileptic seizures (ES), leading to erroneous diagnosis and inappropriate treatments. A critical gap in the diagnostic assessment of seizures is a blood test that can distinguish ES from PNES (2). Both diagnoses were confirmed by the gold standard diagnostic method video/electroencephalogram (EEG) monitoring (3). Taking all in to account, the notion that neuro-inflammation is the key pathology behind focal epileptic seizure initiation and maintenance and the dynamic and adaptative process of neuro -inflammation is associated with blood-brain-barrier disruption and glial activation is no longer a surprise (4).

Tumor necrosis factor related apoptosis inducing ligand (TRAIL) regulates immune responses via apoptosis, with lower levels associated with severe infection, including sepsis (5). Monocyte chemoattractant protein-2 (MCP-2) has been well recognized to participate in immune regulation via binding to chemokine receptors and activation chemotaxis in lymphocytes T, natural killer (NK) cells, and monocytes therefore contributing to the pathogenesis of monocyte-dependent tissue injury (6). Hence, MCP-2 overexpression could result in an increased immune response. Further, since increased levels of MCP-2 have been observed in patients with Alzheimer's disease, this may further support the existence of the biodirections relationship between neurodegeneration and seizures/epilepsy (7).

Eligibility criteria: Inclusion Criteria:

* patients diagnosed as epileptic seizure are aged \>12 years patients diagnosed as psychogenic non-epileptic seizure are aged \>12 years Normal healthy control for comparison. Heathy control are aged \>12 years with no history of lifetime seizures or suspected seizures or febrile seizure and no treatment with an antiepileptic drug (AED) prior to blood draw

Exclusion Criteria:

* Neurological criteria: Other CNS disorders including Parkinson's disease, amyotrophic lateral sclerosis ,cerebrovascular stroke, Psychiatric disorders {major depression disorder , generalized anxiety, mania and other psychiatric diseases).

Others: Tumors and cardiovascular

Primary outcomes:
measure: 1- Evaluation of the role of TRAIL and MCP-2 in differentiation between epileptic seizure and psychogenic non-epileptic seizure
timeFrame: in first 24 hours of seizure
measure: 2- Possible role to predict the prognosis of patients with epileptic seizure.
timeFrame: in first 24 hours of seizure
Secondary outcomes:
Other outcomes:
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