Increased Post-Seizure ACTH Peak May Have a Role in the Benign Characteristics of Febrile Seizures


Elif Özcan, Sevim Şahin, Pınar Özkan Kart, Nihal Yıldız, Serap Özer Yaman, Ali Cansu

Objective: There is substantial evidence about the role of inflammation in the pathogenesis of febrile seizures (FS). However, those studies are mostly about the cytokines. We aimed to elucidate the role of other molecular mechanisms in the inflammatory process. Methods: The study comprised patients aged six months to six years old with FS (n=29), afebrile seizures (S group, n=17), and fever without seizures (F group, n=30). Total leukocyte count, and serum CRP, fibrinogen, complement-C3, -C4, intercellular and vascular adhesion molecules (ICAM1, VCAM1), ACTH and cortisol levels were measured at arrival or after seizure, in all groups; and also, at 24th hour in the FS and S groups. Results: Age and gender distribution were similar between groups. Initially, the FS group's ACTH and cortisol levels were higher than the F and S groups, respectively (p=0.001, p=0.032). At the 24th hour, the greatest decrease in ACTH levels was in the FS group (p=0.004). In comparison of the levels at initial and 24th hour, VCAM1 increased in the FS (p=0.001) and ICAM1 increased in the S groups (p=0.035). The post-seizure leukocyte count was higher in both FS and S groups than the levels at 24th hour (p=0.000, p=0.023). There was a negative correlation between complement-C3 level and age at first FS (r= -0.396, p=0.037). Conclusion: In the FS group, the higher ACTH peak following seizure, considering its protective effects on blood-brain permeability and its role in the anti-inflammatory response, may be a reason for the self-limiting character of simple FS.
Keywords: ACTH, adhesion molecules, febrile seizure, inflammation

Elif Özcan
Karadeniz Technical University
Turkey

Sevim Şahin
Karadeniz Technical University
Turkey

Pınar Özkan Kart
Karadeniz Technical University
Turkey

Nihal Yıldız
Karadeniz Technical University
Turkey

Serap Özer Yaman
Karadeniz Technical University
Turkey

Ali Cansu
Karadeniz Technical University
Turkey

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Pınar Özkan Kart 
Karadeniz Technical University Turkey