Volume 30, Issue 174, August 2026

Candidate Biomarkers in Pediatric Epilepsy: A Narrative Review of Clinical Applications and Translational Challenges

Zofia Hałabuda^♦, Małgorzata Witaszczyk², Oliwia Wróblewska³, Maria Jędryka⁴, Julia Paczyna⁵, Alicja Benecka⁶, Iwona Kawka-Bryk⁷, Jakub Majewski⁸

¹The Floriana Ceynowa Specialist Hospital in Wejherowo, ul. dr. A. Jagalskiego 10, 84-200 Wejherowo, Poland
²University Clinical Center of the Medical University of Silesia in Katowice, Medyków 14, 40-752 Katowice, Poland
³University Clinical Center of the Medical University of Silesia in Katowice, Medyków 14, 40-752 Katowice, Poland
⁴Public Health Care Institution in Oława, Baczyńskiego 1, 55-200 Oława, Poland
⁵Regional Specialized Hospital No. 4, Aleja Legionów 10, 41-902 Bytom, Poland
⁶Prof. S. T. Dąbrowski Hospital in Puszczykowo S.A., Józefa Ignacego Kraszewskiego 11, 62-040 Puszczykowo, Poland
⁷Medical University of Lublin, Aleje Racławickie 1, 20-059 Lublin. Poland
⁸Hospital Murcki Limited Liability Company, Sokołowskiego 2, 40-749 Katowice, Poland

^♦Corresponding author
Zofia Hałabuda, MD, The Floriana Ceynowy Specialist Hospital in Wejherowo, ul. dr. A. Jagalskiego 10, 84-200 Wejherowo, Poland

ABSTRACT

Background: Pediatric epilepsy is a complex and varied group of conditions with different etiologies, seizure types, developmental trajectories, and treatment responses. Potential biomarkers have been investigated to improve etiologic classification, prognostic assessment, disease monitoring, seizure forecasting, and presurgical evaluation. Objectives: To narratively synthesize current evidence on biomarkers with potential clinical applications in pediatric epilepsy, focusing on biological rationale, clinical applications, methodological limitations, and translational status. Methods: A narrative review of English-language articles published from January 2016 to June 15, 2026 was conducted using PubMed. Earlier publications were included when fundamental to biomarker definitions, diagnostic criteria, or methodological concepts. Studies were selected according to their relevance to the review objectives. Findings were synthesized narratively because of heterogeneity in populations, biomarker definitions, analytical methods, and outcomes. Results: Candidate fluid biomarkers included neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE), and S100B. MicroRNAs, pathogenic genetic variants, and epigenetic signatures were identified as candidate molecular biomarkers, while quantitative neuroimaging and electrophysiological features may represent candidate neurodiagnostic biomarkers. Potential applications included assessment of seizure activity, neuronal or glial injury, epilepsy etiology, drug-resistant epilepsy, prognosis, and presurgical evaluation. However, evidence remains limited by small and heterogeneous cohorts, methodological variability, inconsistent definitions, and lack of external validation. Conclusions: Genetic testing has reached the most advanced stage of clinical implementation, particularly in selected pediatric epilepsy syndromes. Most other biomarkers remain under investigation. Further research is needed to establish clinical validity and utility.

Keywords: pediatric epilepsy; biomarkers; neurofilament light chain; microRNA; neuroimaging; electroencephalography; precision medicine; narrative review

Medical Science, 2026, 30, e179ms3967

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DOI: https://doi.org/10.54905/disssi.v30i174.e179ms3967

Published: 30 August 2026