- •The occurrence of PSE was significantly correlated with NLR levels.
- •After adjusting for potential confounders, high NLR was independently associated with an increased risk of PSE.
- •NLR levels were independently associated with the occurrence of PSE in the poor functional outcome group, while this association was not significant in the favorable functional outcome group.
- •The model (cortical involvement + hematoma volume + early seizures + NLR) showed good prognostic performance.
Post-stroke epilepsy (PSE) is one of the major sequelae of stroke. Inflammation has been implicated in the development of stroke. The study aimed to explore the relationship between neutrophil-to-lymphocyte ratio (NLR) levels and epilepsy in patients with primary intracerebral hemorrhage (ICH).
A retrospective study was performed on 1132 patients with first-time ICH. Blood samples were obtained at admission after ICH. Patients included in the study were classified into three groups according to NLR tertiles. Logistic regression was used to analyze the relationship between NLR levels and the occurrence of PSE.
The occurrence of PSE was significantly correlated with NLR levels (r = 0.118, P < 0.001). Patients with PSE had higher NLR levels than those without PSE. After adjusting for potential confounders, high NLR was independently associated with an increased risk of PSE (OR = 1.861, 95% CI 1.032–3.355, P = 0.039). Neutrophil-to-lymphocyte ratio levels were independently associated with the occurrence of PSE in the poor functional outcome group, while this association was not significant in the favorable functional outcome group. The model (cortical involvement + hematoma volume + early seizures + NLR) showed good prognostic performance.
High NLR at admission is associated with an increased risk of PSE, which suggests that NLR may play a role in risk stratification in patients with ICH.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Epilepsy & Behavior
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Epilepsy in older people.Lancet (London, England). 2020; 395: 735-748
- Incidence, Implications, and Management of Seizures Following Ischemic and Hemorrhagic Stroke.Curr Neurol Neurosci Rep. 2019; 19: 37
- Poststroke epilepsy in long-term survivors of primary intracerebral hemorrhage.Neurology. 2017; 88: 2169-2175
- Diagnosis and Management of Acute Ischemic Stroke.Mayo Clin Proc. 2018; 93: 523-538
- Increased mortality after post-stroke epilepsy following primary intracerebral hemorrhage.Epilepsy Res. 2021; 172106586
- Seizures and epilepsy after intracerebral hemorrhage: an update.J Neurol. 2021; 268: 2605-2615
- The Progress of Epilepsy after Stroke.Curr Neuropharmacol. 2018; 16: 71-78
- Lymphocyte infiltration of neocortex and hippocampus after a single brief seizure in mice.Brain Behav Immun. 2010; 24: 263-272
- Brain expression of inflammatory mediators in Mesial Temporal Lobe Epilepsy patients.J Neuroimmunol. 2017; 313: 82-88
- The role of inflammation in the development of epilepsy.J Neuroinflammation. 2018; 15: 144
- Inflammation Mediated Epileptogenesis as Possible Mechanism Underlying Ischemic Post-stroke Epilepsy.Front Aging Neurosci. 2021; 13781174
- Potential therapeutic targets for intracerebral hemorrhage-associated inflammation: An update.J Cereb Blood Flow Metab. 2020; 40: 1752-1768
- Emerging Role of Microglia-Mediated Neuroinflammation in Epilepsy after Subarachnoid Hemorrhage.Mol Neurobiol. 2021; 58: 2780-2791
- Neutrophil-to-Lymphocyte Ratio in Acute Cerebral Hemorrhage: a System Review.Transl Stroke Res. 2019; 10: 137-145
- Prognostic role of pretreatment blood neutrophil-to-lymphocyte ratio in advanced cancer survivors: A systematic review and meta-analysis of 66 cohort studies.Cancer Treat Rev. 2017; 58: 1-13
- The Predictive role of Neutrophil-to-Lymphocyte Ratio (NLR) and Mean Platelet Volume-to-Lymphocyte Ratio (MPVLR) for Cardiovascular Events in Adult Patients with Acute Heart Failure.Mediators Inflamm. 2021; 2021: 6889733
- Neutrophil-to-Lymphocyte Ratio as an Independent Predictor of In-Hospital Mortality in Patients with Acute Intracerebral Hemorrhage.Medicina (Kaunas). 2021; 57
- Neutrophil to Lymphocyte Ratio in Epilepsy: A Systematic Review.Mediators Inflamm. 2022; 2022: 4973996
- The ABCs of measuring intracerebral hemorrhage volumes.Stroke. 1996; 27: 1304-1305
- Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE).Epilepsia. 2005; 46: 470-472
- Commonalities in epileptogenic processes from different acute brain insults: Do they translate?.Epilepsia. 2018; 59: 37-66
- Inflammatory responses after intracerebral hemorrhage: From cellular function to therapeutic targets.J Cereb Blood Flow Metab. 2019; 39: 184-186
- Dysfunctional epileptic neuronal circuits and dysmorphic dendritic spines are mitigated by platelet-activating factor receptor antagonism.Sci Rep. 2016; 6: 30298
- Antagonism of peripheral inflammation reduces the severity of status epilepticus.Neurobiol Dis. 2009; 33: 171-181
- The role of inflammation in epilepsy.Nat Rev Neurol. 2011; 7: 31-40
- Region-specific plasticity in the epileptic rat brain: a hippocampal and extrahippocampal analysis.Epilepsia. 2009; 50: 537-549
- Albumin induces excitatory synaptogenesis through astrocytic TGF-β/ALK5 signaling in a model of acquired epilepsy following blood-brain barrier dysfunction.Neurobiol Dis. 2015; 78: 115-125
- Prognostic Role of the Neutrophil-to-Lymphocyte Ratio in Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis.Front Neurosci. 2022; 16825859
- Inflammation after intracerebral hemorrhage.J Cereb Blood Flow Metab. 2007; 27: 894-908
- Neutrophil extracellular traps, released from neutrophil, promote microglia inflammation and contribute to poor outcome in subarachnoid hemorrhage.Aging. 2021; 13: 13108-13123
- Changes in serum albumin levels and neutrophil-lymphocyte ratio in patients with convulsive status epilepticus.Int J Neurosci. 2017; 127: 417-420
- Neutrophil depletion reduces blood-brain barrier breakdown, axon injury, and inflammation after intracerebral hemorrhage.J Neuropathol Exp Neurol. 2011; 70: 218-235
- Protective autoimmunity and neuroprotection in inflammatory and noninflammatory neurodegenerative diseases.J Neurol Sci. 2005; 233: 163-166
- Predictors of Pharmaco-Resistance in Patients with Post-Stroke Epilepsy.Brain Sci. 2021; 11
- Latency of poststroke epilepsy can predict drug resistance.Eur J Neurol. 2022; 29: 2481-2485
- Temporal lobe epilepsy: Evaluation of central and systemic immune-inflammatory features associated with drug resistance.Seizure. 2021; 91: 447-455
Published online: March 22, 2023
Accepted: March 9, 2023
Received in revised form: February 24, 2023
Received: December 18, 2022
© 2023 Elsevier Inc. All rights reserved.