The interrelationship between clinical and immunity variables in epilepsy

Abstract

Summary Introduction. The role of cellular immunity in the pathogenesis of epilepsy, as an interaction between immunity and clinical and neurobiological variables is not properly understood. Aim. The aim of the current study was to investigate the possible relationship between epilepsy forms, gender, focus localization, lateralization, handedness and cellular immunity with seizures frequency, their severity and length of therapeutic remission in partial forms of epilepsy. Material and methods. Ninety two patients (38 men and 54 women) were included in the study. Symptomatic epilepsy was diagnosed in 40 patients and the cryptogenic form was diagnosed in 52 patients. The amount of different lymphocyte clusters were evaluated and they were transformed into nominal variables for MANOVA analysis. MANOVA was used for the analysis of the interrelationship between nominal fixed factors (epilepsy forms, gender, handedness, and focus laterality, and immunity variables) and dependent variables (remission and seizure frequency and their severity). Results. Simple partial seizure (SPS) and complex partial seizure (CPS) frequencies were under the influence of interaction between immune and neurobiological variables. SPS, and in particular sensory SPS, were associated with CD4/CD8 ratio, gender, left temporal focus and handedness. The highest frequencies of SPS were revealed in cases of low CD4/CD8 ratio combined with left temporal focus, female gender and left-handedness. The maximal CPS frequency was observed in patients with a left frontal focus combined with a high B-lymphocyte level. The more severe seizures were revealed in left-handers with low CD8 and high CD4/CD8 ratio and in frontal left focus and a high T-lymphocyte level. There was a correlation between CD4 cell level and length of remission. Conclusion. The complex multifarious connections between neurobiological, immune and clinical variables in patients with partial forms of epilepsy really exist.