The Predictive Role of Neutrophil-to-LymPhocyte Ratio in Seizure Recurrence in Patients with Epilepsy

Abstract

Background: The aim of this retrospective study was to investigate the importance of leukocyte, neutrophil, lymphocyte, and neutrophil/ lymphocyte (NLR) ratios in epileptic seizure recurrence and whether there is a relationship between them. Objectives: To evaluate the predictive value of leukocyte, neutrophil, lymphocyte, and monocyte parameters in assessing the likelihood of seizure recurrence in epilepsy patients. Materials and Methods: Sixty-five epilepsy patients who were on follow-up for epilepsy were included in the study. The study group consisted of epilepsy patients who had routine complete blood counts taken within the first 24 hours of emergency room visits due to seizures and for control purposes at outpatient clinic visits. The parameters examined were leukocyte, neutrophil, lymphocyte, platelet counts (PLT) (×10³ mm³), mean platelet volume (MPV), and NLR. NLR was calculated by dividing the absolute number of neutrophils by the absolute number of lymphocytes. Results: Leukocyte, neutrophil, NLR, and monocyte values (P < 0.001) were significantly higher in patients with seizure recurrence in the first 30 days compared to those without recurrence. The predictive value of leukocyte, neutrophil, NLR, and monocyte parameters for seizure recurrence was assessed using receiver operating characteristic (ROC) analysis. Since the area under the curve (AUC) value for NLR was larger than that of neutrophil and monocyte values, the diagnostic performance of NLR was found to be superior. For NLR, the AUC value was 0.73 (95% confidence interval: 0.639–0.807, P = 0.0001), with sensitivity and specificity of 52.31% and 94.23%, respectively. NLR had the highest predictive value for seizure recurrence. Conclusions: Our study suggests that neutrophilmediated inflammation plays a role in epileptic seizures and that monocyte values are also important. NLR and monocyte values may serve as predictive biomarkers for seizure recurrence. © 2025 Acta Neurologica Taiwanica.