Recent research in pediatric epilepsy has identified several categories of serum biomarkers that may correlate with seizure control, including inflammatory cytokines, neurotrophic factors, markers of neuronal injury, and metabolic signatures. For example, elevated pro-inflammatory cytokines (such as certain interleukins and chemokines) are often found in children with more severe or drug-resistant seizures, suggesting an underlying neuroinflammatory contribution, while altered levels of neurotrophic factors like brain-derived neurotrophic factor (BDNF) have been linked to higher seizure frequency and neuronal hyperexcitability.

Markers of neuronal injury (for instance, the glial protein S100B) tend to be increased in active epilepsy, indicating ongoing neural damage, and metabolomic profiling has revealed distinct metabolic signatures (reflecting changes in energy and neurotransmitter metabolism) associated with epilepsy and treatment response. Although these biomarker findings are promising in relating to seizure severity and drug resistance, the evidence remains largely exploratory and none have been clinically validated for routine use. microRNAs have emerged as a novel class of serum biomarkers, with certain circulating microRNAs showing potential associations with seizure activity and pharmacoresistant epilepsy.

CNKE.ORG has an article on biomarkers in epilepsy