Effect Of Methylprednisolone Shock Therapy On Immune Function Of Electrical Status Epilepticus During Sleep In Children

Objective:To study and analyze the immune function of electrical status epilepticus during sleep(ESES)in children;to explore the immune function and efficacy of MP shock therapy before and after methylprednisolone(MP)shock therapy,to explore the immunological mechanism of MP shock therapy Sexual targeted immunotherapy offers new directions.Methods:From October 2017 to October 2018,we were hospitalized in the Pediatric Neurology Unit of Shengjing Hospital affiliated to China Medical University.A total of 19 children with newly diagnosed temporal lobe epilepsy(TLE)were enrolled.The initial diagnosis of temporal lobe epilepsy with ESES(ESES)Children,a total of 16 cases;oral administration of more than 2 anti-epileptic drugs(AEDs)ineffective children with ESES,a total of 32 cases,given MP shock treatment for 3 days;in the same period,children’s health care physical examination children,a total of 21 cases.Flow cytometry was used to detect the surface molecules of lymphocytes(T,B,NK)in each group.Peripheral serum cytokines were determined by enzyme-linked immunosorbent assay(IL-2,IL-4,IL-6,IL-10,IL-17,INF-γ,TNF).Results:(1)The average duration of ESES in children with ineffective AEDs was 2.5 years.78% of children had oral administration of more than 3 antiepileptic drugs.Some children had mental,motor development,language development and sleep disorders,suggesting that the longer the course of disease,The worse the prognosis.(2)Compared with normal children,the NK cell activity was significantly lower in children with newly diagnosed ESES(P<0.05).The level of IL-6 was higher in children with newly diagnosed ESES compared with children with TLE.The significance of learning(P<0.05);Compared with the immune function of children with ESES before and after treatment with AEDs,the levels of IL-2 and IL-6 were significantly lower(P<0.05).(3)In children with ESES who had poor therapeutic effect of oral AEDs,the proportion of peripheral blood B lymphocytes increased after MP shock treatment,and the proportion of T lymphocyte subsets and NK cells decreased.The difference of each group was statistically significant(P <0.05);IL-2,IL-4,IL-10 levels were higher than before treatment,IL-6,IL-17,INF-γ,TNF levels were lower than before treatment,and the difference in IL-6 levels was statistically significant.The significance of learning(P<0.05);the effective rate of EEG decreased by 53% after treatment,some children’s growth and development and cognitive function improved,all children without serious infection,high blood pressure,electrolyte imbalance and other adverse reactions;treatment effect The correlation with the changes of immune index was statistically significant in NK cells,B lymphocytes and IL-6 levels,and all of them were positively correlated(P<0.05).Conclusions:1.ESES patients themselves have immune dysfunction,there may be excessive inactivation of NK cells and elevated levels of IL-6.Congenital immunity and adaptive immunity may play a role in the pathogenesis and pathophysiology of ESES syndrome.2.AEDs can reduce IL-2 and IL-6 levels,and the mechanism of action may be related to it;3.MP shock therapy can significantly reduce the NREM discharge index in children with ESES.The mechanism may be related to the significant decrease of IL-6 level.It may also be related to redistribution of lymphocyte subsets,affecting cell differentiation and balancing various cytokines.