Epilepsy is highly prevalent among children, making it one of the most common neurological diseases in the pediatric population. Its diagnosis is problematic, largely depending on clinical judgment and inaccurate investigative studies. Thus, a more objective investigation is warranted. MicroRNAs (miRNAs) are small molecules found in various body fluids and tissues that prove to have potential, as they play an important role in the pathogenesis of epilepsy. This review evaluates the use of miRNAs in the diagnosis, prediction, and prognosis of pediatric epilepsy. Furthermore, it discusses the use of miRNAs as therapeutic agents and the relationship between miRNAs and antiepileptic drugs (AEDs).
From inception until 7 July 2024, a thorough search of PubMed, Europe PMC, PubMed Central, and Google Scholar was conducted.
Our review is based on 18 studies on pediatric patients with epilepsy according to the selection criteria. A total of 33 different miRNAs for diagnosis, 13 for prediction, and 2 for prognosis of pediatric epilepsy in a total sample size of 663, 111, and 163 pediatric patients, respectively, in addition to 20 miRNAs for the diagnosis of focal epilepsy, and a further 4 for generalized epilepsy in the same population were interpreted in our systematic review.
These studies suggest that miRNA usage as a diagnostic, predictive, and prognostic biomarker for pediatric patients with epilepsy is promising. However, further research on that population is needed, as the number of studies is limited, with several bias concerns and heterogeneity, with the need for clinical trials to assess the use of miRNAs as drug agents. PROSPERO registration no. ID: PROSPERO 2024 CRD42024578258.

© 2025. The Author(s).