Time courses of HMGB1 and other inflammatory markers after generalized convulsive seizures

•Generalized convulsive seizures concur with increased inflammatory markers in blood.•HMGB1, S100 and leukocytes rise immediately after the seizure.•Elevations of MMP9 and CRP can be found later on.•This indicates irritations of the blood brain barrier and a systemic inflammatory response.•Markers of metabolic stress are correlated with these inflammatory changes. Neuroinflammation and disruption of blood brain barrier (BBB) are important players in epileptogenesis, ictogenesis and pharmacoresistance. In this context, we investigated blood levels of HMGB1 and other inflammatory and BBB markers after generalized and focal to bilateral tonic-clonic seizures in serum, summarized under the term generalized convulsive seizures (GCS). We included consenting adults who were admitted to the epilepsy monitoring unit. Blood samples were drawn at baseline and immediately after a GCS as well as after 2, 6 and 24 h. We measured leukocytes, c-reactive protein (CRP), the danger-associated molecular patterns (DAMPs) high mobility group box 1 (HMGB1) and S100, receptor of advanced glycation end products (RAGE) alongside the BBB markers intercellular adhesion molecule-1 (ICAM1) and matrix metalloproteinase 9 (MMP9). Noradrenaline and lactate measurements were available from a previous study. P-levels