Introduction – Febrile seizures (FS) are the most common cause of convulsions in children in Asia. Immune-mediated inflammation is believed to play a role in the pathogenesis of FS. This study aims to compare the association of pro-inflammatory (serum IL-1beta, IL-6) vs anti-inflammatory (serum IL-4) cytokines between FS (cases) and non-seizure febrile illnesses (controls) in children aged 6 months to 6 years.

Methods – Cases (n=25) and controls (n=25) including 12 simple FS (SFS) and 13 complex FS (CFS) were recruited from the apex tertiary care children’s hospital in Sri Lanka between January and October 2023. Serum cytokine levels were measured using Enzyme-Linked Immunosorbent Assays (ELISA).

Results – The levels of IL-1beta (64.38±8.25 pg/ml vs. 63.27±5.61 pg/ml) and IL-4 (1.21±1.36 pg/ml vs. 0.52±0.45 pg/ml) were elevated while IL-6 (59.73±46.89 pg/ml vs 72.68±62.27 pg/ml) was decreased in cases compared to controls (p>0.05). The IL-6: IL-4 ratio (588.43±1389.39 vs 206.13±225.68) was significantly higher in cases compared to controls (p=0.037). A positive correlation was identified between IL-1beta and IL-4 exclusively in cases (r=0.446; p=0.025). Serum IL-1beta was higher in CFS compared to SFS (IL-1beta: 68.06±9.41 pg/ml vs. 60.4±4.3 pg/ml; p=0.024, IL-4: 1.63±1.70 vs 0.76±0.67 pg/ml; p>0.05 and IL-6: 49.93±38.52 vs 70.34±54.26 pg/ml; p>0.05).

Conclusions – A pro-inflammatory cytokine biased immune response may contribute to the pathogenesis of FS.

Disclosures – This work was funded by the Association of Sri Lankan Neurologists Annual Research Grant 2022-2023 under grant reference number ASN/2023/04/02/01.

Damindri Herath
Faculty of Science, University of Colombo
Sri Lanka

Devaka Weerakoon
Faculty of Science, University of Colombo
Sri Lanka

Thashi Chang
Faculty of Medicine, University of Colombo
Sri Lanka

Jithangi Wanigasinghe
University of Colombo
Sri Lanka