A Case-Control Study of Neutrophil-Lymphocyte Ratio as a Biomarker of Inflammation in Adults with Epilepsy

Abstract

Background: There is growing evidence that inflammation plays a specific role in the pathogenesis of epilepsy and seizures also induce inflammation. The Neutrophil/Lymphocyte ratio (NLR) is an emerging inflammatory biomarker of epilepsy.

Objectives: To determine the association between epilepsy and Neutrophil /Lymphocyte Ratio among adults.

Methods: Adults with epilepsies the attending outpatient neurology clinics at two Nigerian tertiary health facilities, were recruited. One hundred cases and one hundred age-matched, healthy controls were recruited. The total white blood cell (WBC) and its differential counts were extracted from Full Blood Count (FBC) results and NLR was calculated. The predictors of the association between WBC parameters and epilepsy were established using a linear regression model derived from WBC parameters associated with epilepsy.

Results: Out of 100 cases and controls, there was no gender-related statistical difference between the cases and controls (p = 0.777). There was no difference between the mean ages of cases and control (p = 0.058). The total mean white blood cell count among the cases was 8.80±9.84×10⁹ cells/L compared to was 6.30±1.90 ×10⁹ cells/L in the controls, (p = 0.013). The mean neutrophil count in the cases was 59.00±17.89 ×10⁹ cells/L compared to 49.50±15.44 ×10⁹ cells/L among the controls (p < 0.001). The mean NLR for the cases was 4.24±10.44 compared to 1.84±2.26 in the controls (p = 0.026). The Neutrophil/Lymphocyte Ratio (p = 0.013) and Basophil (p < 0.001) predicted epilepsy on linear regression analysis.

Conclusion: This study shows a clear difference in the TWBC and NLR with between adults with epilepsies and health controls.