Tissue plasminogen activator in children with idiopathic and intractable epilepsies

Abstract

We aimed to assess serum level of tissue plasminogen activator (tPA) in children with idiopathic epilepsy aiming to find a pathogenic relationship and correlate it with disease intractability, severity, effect of antiepileptic drug therapy and epilepsy control. The study comprised of 24 children with idiopathic epilepsy either on monotherapy or polytherapy. Sixteen children with controlled idiopathic focal and generalized epilepsy while eight were intractable to antiepileptic drugs treatment. Serum tissue plasminogen activator was assessed in the patient group and compared to non-epileptic healthy controls; furthermore, the level of tPA was correlated to the epilepsy severity. Level of tPA was significantly increased in epileptic patients compared to controls (6.11 ± 6.11 ng/dL, and 2.61 ± 1.69 ng/dL, respectively) (P < 0.001). Among the epileptic patient group, serum level of tPA was significantly increased in the intractable group compared to the controlled focal group and controlled generalized group. Also, serum tPA was significantly increased in patients on antiepileptic drugs polytherapy compared to patients on monotherapy. Increased serum tPA level was positively correlated with the epilepsy severity (r = 0.612; P < 0.001). Hence, tPA could be one of the pathogenic endogenously produced chemical substances linked to childhood epilepsy and potential marker of epilepsy intractability.

Keywords

Childhood epilepsy - tissue plasminogen activator