***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: OBJECTIVE We analyzed cytokines levels in patients with epilepsy and new onset seizure and correlated it with various parameters . MATERIAL S AND METHODS After obtaining consent , serum sample s from 100 patients with epilepsy or new onset seizure were prospect ively collected in the immediate post-ictal phase . In 16 patients , a second sample was collected during the seizure-free period . The serum cytokine levels [ TNF-alpha , IFN-gamma , IL-1beta , IL-2 , IL-4 , and IL-6 ] were assessed ( ELISA ) in these patients and 100 matched healthy controls .  CSF analysis  was carried out in 9 patients of this cohort , when clinical ly indicated . RESULTS The type of seizures ( n=100 ) was major ( 45 ) , partial ( 41 ) and status epilepticus ( SE=14 ) , while the epilepsy syndromes were idiopathic generalized ( 53 ) and localization related ( 47 ) . The detectable serum cytokines in the patient group ( n=100 ) were : IL-6 ( 42 ) , TNF-alpha ( 36 ) , IL-2 ( 22 ) , IL-4 ( 22 ) , IFN-gamma ( 20 ) and IL-1 ( 11 ) compared to the controls . CSF IL-6 and IL-1 was detectable in 4/9 and 2/9 patients , respectively while , IL-2 , IL-4 , IFN-gamma was detectable 1 in each patient . Correlations were noted between male gender and IL-1beta ( p=0.04 ) , positive family history and IL-1beta ( p=0.001 ) , " no alcohol use " and TNF-alpha ( p=0.05 ) , more than one year history of epilepsy and IL-1beta ( p=0.02 ) , status epilepticus ( SE ) and IL-6 ( p=0.04 ) . There was no difference between the new onset seizures vs. epilepsy group . Serial analysis during the seizure-free period revealed a decrease in cytokine levels : TNF-alpha ( 25 % to 12.5 % ) , IFN-gamma ( 12.5 % to 0 % ) , IL-1 ( 25 % to 0 ) and IL-2 ( 6.2 % to 6.2 % ) , IL-4 ( 18.8 % to 0 % ) and IL-6 ( 18.8 % to 6.2 % ) . CONCLUSIONS We found increased post-ictal serum cytokine levels in patients with several epilepsy syndromes PURPOSE Several studies have reported favorable effects of intravenous immunoglobulins ( IVIG ) in refractory epilepsy . Evidence substantiating an immunomodulatory action is scarce . In an open-label study , we prospect ively investigated the effect of IVIG on clinical , EEG and serum/CSF immunological parameters in patients with refractory childhood-onset epilepsy . METHODS Thirteen patients ( median age 6.9 years ; range 1.6 - 25.8 ) with refractory seizures despite 3 - 4 antiepileptic drug regimens were given IVIG ( S and oglobulin , ZLB-Behring , add-on , 4 x 400 mg/kg/3 weeks ) . Seizure frequency , 24-h video-EEG , and CSF/serum immunological parameters and cytokine profiles ( IL-6/IL-8/IL-12/IL-10 ) were documented before and after completion of the course . RESULTS Seizure frequency was reduced by > or = 50 % in four , and by 25%-50 % in three patients . In contrast , variation in automatically recorded spike counts ( 1-h-wake and -sleep ) did not correlate with clinical improvement . Serum immunological parameters showed variable deviations in eight patients ( e.g. , IgG(2 ) deficiency ) and CSF immunoblotting showed oligoclonal b and s in two patients . Blood-brain barrier permeability was normal in 12 patients . IL-6 and IL-8 were clearly detectable in CSF of all patients ; the levels were significantly higher than those in plasma but remained unaffected by IVIG treatment . CONCLUSIONS Despite unchanged EEG spike counts , substantial reductions in seizure frequency occurred in 7 of 13 patients , suggesting that IVIG hinder progression of central epileptic activity into clinical seizures . Intrathecal presence of IL-8 and IL-6 was documented in all patients , but was unaffected by IVIG , suggesting that their production is directly related to electrical seizure activity and that IVIG may act through interference with immune pathways downstream to IL-6 and IL-8 Abstract To quantify the risk of febrile seizures ( FS ) in relatives of children with FS and to predict the risk of FS in siblings , we calculated cumulative risks of FS in first degree relatives of 129 children with FS . The study was conducted as a prospect i ve follow up study of FS recurrences at the outpatient clinic of the Sophia Children 's Hospital in Rotterdam . Thirteen parents and 12 siblings had experienced FS , accounting for a 6-year cumulative risk of 7 % . The risk of FS was increased in relatives of children with recurrent FS ( 12 % ) . The risk of FS in siblings ( 10 % ) in our study was more than twice the average risk in a similar population ( 4 % ) . A positive FS history in a parent , young age at onset in the prob and , and recurrences in the prob and were selected in a multivariable prediction model . If two or more of these risk factors were present , the risk of West European siblings to develop FS was 46 % ( hazard ratio 5.4 ) . Conclusion The cumulative risk of FS in siblings of children with FS is increased . The age attained risk of FS can be estimated using a practical model incorporating three readily available risk factors In a prospect i ve r and omised study , 289 children admitted consecutively to hospital with their first febrile seizure were allocated , by date of admission , to short term diazepam prophylaxis ( n = 152 ) or to no prophylaxis ( n = 137 ) and followed for 18 months . In untreated children , five major risk factors for recurrent febrile convulsions were identified : age 15 months or less at the time of the first febrile seizure , epilepsy in first degree relatives , febrile convulsions in first degree relatives , a first complex febrile seizure , and day nursery care . The 18 month recurrence rate was 80 to 100 % if three to five risk factors were present , 50 % if two factors were identified , 25 % where one factor was found , and 12 % if there were no predictors . During prophylaxis the recurrence rate was uniformly low ( mean 12 % ) in all risk groups . In high ( three or more factors ) and intermediate ( two factors ) risk children prophylaxis provided effective seizure control and reduced the recurrence rate from 80 % , or more , to 12 % and 50 % to 12 % , respectively . In children with one risk factor 50 % of all recurrences were prevented ( 25 % to 12 % ) . Prophylaxis was ineffective in very low risk children ( 12 % to 12 % ) We have previously reported increased concentrations of interleukin (1L)-6 in CSF from patients with tonic-clonic seizures , where increased cytokine production most likely is a consequence of neuronal epileptic activity associated with seizures . The biological effects of IL-6 are mediated by other cytokines , which are studied here in addition to IL-6 . The purpose of this study was to analyze levels of soluble cytokines from plasma and CSF from patients with newly developed tonic-clonic seizures . The concentrations of IL-6 , IL-1 receptor antagonist ( IL-1RA ) , IL-1beta , tumor necrosis factor ( TNFalpha ) and nerve growth factor ( NGF ) were measured from plasma and CSF from 22 patients with newly developed tonic-clonic seizures within 24 h from the seizure and 18 controls . The mean concentrations of IL-6 were significantly increased in CSF ( P<0.001 ) and plasma ( P<0.01 ) after tonic-clonic seizures , there was some indication of increased concentrations of IL-1RA and no significant change in NGF , IL-1beta or TNFalpha . Our study shows that cytokine network is activated in patients after recent tonic-clonic seizures . We provide evidence of intrathecal production of IL-6 associated with electrical seizure activity OBJECTIVES The aim of this study was to determine the association between iron status and febrile seizures in children aged 6 months to 5 years . METHODS This prospect i ve case-control study enrolled 300 children who presented with febrile seizures ( case group ) and 200 children who presented with a febrile illness without seizures ( control group ) from March 2007 to January 2009 .  Hemoglobin , mean corpuscular volume and serum ferritin concentration were compared in the two groups in relation to age , sex and use of iron supplementation . RESULTS Patients with febrile seizures were more frequently iron deficient as defined by a serum ferritin level below 20 ng/dl ( 56.6 % vs. 24.8 % , P=0.0001 ) . Mean hemoglobin concentration was 10.8 g/dl in the control group and 11.7 g/dl in the case group ( P<0.05 ) . The difference between groups in mean corpuscular volume was not statistically significant ( 75.5 fl vs. 74.4 fl , P<0.130 ) . CONCLUSION Low serum ferritin concentration and low iron status may be risk factors for the development of febrile seizures Background : Febrile seizures ( FSs ) are the most common form of childhood seizures , and genetic factors play a role in susceptibility to FS . Objective : To identify novel loci and genes associated with susceptibility to FS . Methods : Study participants were the FS prob and s and family members of 59 Japanese nuclear families ( 223 members including 112 affected children ) . Forty-eight of these families had at least two affected children for which genome-wide linkage screening was carried out . The Genehunter software was used to perform nonparametric multipoint linkage analysis . Mutational and association analyses were conducted in all 59 Japanese FS families . Results : Genotyping data of 407 microsatellite markers suggested linkage of FSs to chromosome 18p11.2 ( non-parametric linkage score = 3.68 , p = 0.0001 ) . This region includes the IMPA2 gene , which encodes myo-inositol monophosphatase ( IMPase ) 2 . In the phosphatidylinositol-signaling pathway , IMPase is inhibited by lithium , which has a proconvulsant effect , and is stimulated by carbamazepine , an anticonvulsant . A systematic search was performed for mutations in IMPA2 in 24 unrelated r and omly selected Japanese FS patients ; seven variants were detected . Haplotype analysis revealed an association of a common haplotype in IMPA2 with FSs ( p = 0.0009 ) . Conclusion : The authors found a novel locus on chromosome 18p11.2 for febrile seizures ( FSs ) . IMPA2 is likely to be an FS susceptibility gene Purpose : A history of febrile convulsions ( FC ) is often obtained in patients presenting for surgical treatment of temporal lobe epilepsy ( TLE ) , but it is not clear that preferential temporal localization of epilepsy is associated with antecedent FC . Methods : We prospect ively inquired about FC and their characteristics in all patients presenting to an epilepsy clinic through a patient question naire and interview .  We studied the incidence of antecedent childhood febrile convulsions in relation to epilepsy diagnosis . Results : FC were reported by 133 of 1005 study patients ( 13.2 % ) . TLE was more likely to be preceded by FC ( 78/310 , 25.2 % ) than extratemporal epilepsy (ETE)(12/216 , 5.6 % ) ( p < 0.000001 ) or generalized epilepsy (GE)(16/146 , 11.0 % ) ( p < 0.001 ) . Patients with GE were more likely than patients with TLE to have had simple FC ( p < 0.00005 ) . Prolonged duration was the most common FC complex feature in TLE patients . Conclusions : We demonstrated a preferential association of FC with temporal lobe foci and a weaker association between FC and GE . FC does not appear to be a clear risk factor for ETE Febrile seizures ( FSs ) are the commonest form of convulsions . A genetic predisposition to FSs is known , based on family studies , twin studies , and complex segregation analysis . Simple FSs may be more homogenous in their clinical manifestations , and show better agreement with the multifactorial inheritance theory than the complex type . Interleukin-1 ( IL-1 ) beta is one of the pro-inflammatory cytokines that are postulated to be involved in the development of FSs . To determine whether or not function-related polymorphisms of the IL-1beta ( IL1B ) gene are associated with susceptibility to simple FSs , the genotypes for two biallelic polymorphisms in the promoter region at positions -31 and -511 of the IL1B gene were determined by means of PCR-restriction fragment length polymorphism in 229 FS patients ( 108 sporadic and 60 familial simple FS , and 
    Output:
    
The present meta- analysis showed that two alleles of proinflammatory cytokines ( IL-1α-889 and IL-1β-511 ) in addition to the serum concentration of IL-6 were significantly associated with FS and epilepsy or both in various subgroup analyses