Serum glial fibrillary acidic protein (GFAP) as a predictor of drug-resistant epilepsy in children
Sameh A.A.A. El-Naby, Ahmed S.A. El-Gawad, Mona A. Meky, Dina A. HammadBackground
Epilepsy is the third most common chronic disorder affecting the brain worldwide. Despite the availability of multiple antiseizure therapies, nearly one-third of affected individuals fail to achieve seizure control. Identifying these patients at an early stage is crucial for appropriate treatment selection and prevention of the devastating consequences of recurrent seizures.
Objective
To evaluate serum glial fibrillary acidic protein (GFAP) as a predictor of drug-resistant epilepsy in children.
Patients and methods
This prospective study included 62 idiopathic epileptic patients who were presented to the outpatient clinic or admitted to the neurology unit in the pediatric department at a tertiary care University Hospital. The study protocol was approved by the institutional ethics committee, and written informed consent was obtained from the parents of all participating children. The study was conducted between May 2024 and August 2025.
Results
According to receiver operating characteristic curve analysis, GFAP levels were found to have a strong predictive ability with an area under the receiver operating characteristic curve of 0.883 (95% CI of 0.795–0.971), using a cut-off level greater than 13.67 ng/ml with 91.35% sensitivity and 77.15% specificity (
Conclusion
GFAP is significantly elevated in the resistant epilepsy group compared with the controlled epilepsy group, supporting its role as a biomarker of astroglial activation and disease activity.