Demonstration of increased hmgb1 level in cerebrospinal fluid of patients WHO had febrile convulsions

Febrile convulsions are defined as seizures triggered by a fever that are not associated with central nervous system infection or metabolic disorder. Febrile convulsions are the most common types of seizures in childhood and their frequency is reported to be 4-5%. In addition, 15% of adults and children receiving treatment for epilepsy also have at least one febrile convulsion history. The inflammatory process triggered by fever and released proinflammatory cytokines have gained importance in the etiopathogenesis of febrile convulsions in recent years. There are studies that set us thinking that increased levels of HMGB1, one of the most important of these cytokines, may be related to prolongation of seizure duration, recurrence of seizures, and the development of epilepsy in the future. In our study, we aimed to show that the HMGB1 level had increased in cerebrospinal fluid of patients between 6 months and 6 years of age who had febrile convulsions. Between April 2016 and April 2018, 40 patients who were applied to Akdeniz University Medical Faculty Hospital due to febrile convulsions and 45 volunteers of the same age group from whom cerebrospinal fluid (CSF) samples were taken due to various complaints other than febrile convulsion were included as a control group in our study. When the CSF HMGB1 level of the group who had febrile convulsions was compared with that of the control group, it was observed that the CSF HMGB1 level of febrile convulsion patients was increased (p: 0.001). In addition, when the subgroups were compared separately, it was seen that the mean CSF HMGB1 level of the group who had complex febrile convulsions was the highest with an average of 3363.9 pg/ml. This increase in patients with complex febrile convulsions was found to be at a significant level according to all subgroups. When the number of seizures and seizure duration of the patients who had febrile compulsions and the CSF HMGB1 levels were compared, a statistically significant positive correlation was found for both variables. According to the research result, the CSF HMGB1 level was found high in patients who had febrile compulsions, and this high level was also found related to seizure recurrence and seizure duration. We are of the opinion that this study will shed light on the determination of the patients who may develop epilepsy in the future, prediction of seizure recurrences and new treatment choices that may contribute to seizure control of these patients.