Immunological Correlates of Adult Onset Idiopathic Generalized Tonic-clonic Epilepsy before and after Sodium Valproate Treatment

Objective: To investigate possible immunological humoral correlates in newly diagnosed adult-onset generalized tonic-clonic epilepsy among Iranian patients before and after sodium valproate treatment.   Patients and Methods: 72 adult patients with newly diagnosed idiopathic generalized tonic-clonic epilepsy were recruited. Serum antinuclear antibodies (ANA), anti-cardiolipin antibodies (aCL), anti-dsDNA antibodies, total serum immunoglobulins (IgM, IgG, IgA) and C3 and C4 complements were determined before and after 12 months of therapy with sodium valproate. Similar parameters were also measured in 32 age and sex-matched healthy volunteers.   Results: Patients group had a significantly greater level of IgG class aCL (30.6% versus 12.4%, P = 0.004) and anti-dsDNA antibodies (23.9% versus 0%, P = 0.001) when compared with healthy volunteers, however, ANA titre was relatively the same in both groups. Sodium valproate significantly decreased anti-dsDNA antibodiles (P = 0.002), IgM concentrations (P = 0.034), and increased the number of ANA positive patients (P = 0.002).   Conclusion: Changes in serum level of autoantibodies in patients with new onset idiopathic generalized convulsion were found to be high. These abnormalities are associated with both seizure disorders per se and also antiepileptic drugs. We suggest that in epileptic patients with an autoimmune basis, administration of anti-epileptic drugs having modulatory effects on immune system should be considered.